脑动静脉畸形的影像学表现比较分析

A comparative analysis on imaging of cerebral arteriovenous malformation

目的探讨脑内动静脉畸形CT、MRI、CTA、MRA、DSA等影像学表现并进行比较分析。方法收集脑动静脉畸形75例,以手术病理及DSA作为诊断的金标准,比较CT、MRI、CTA、MRA、DSA影像学表现,分析各种影像手段的优缺点。结果CT诊断脑动静脉畸形的敏感性89.3%,MR诊断动静脉畸形的敏感性96%。CT呈团块状、蜂窝状、结节状或条索状;MR呈蚯蚓状或线样无信号流空血管影;CT发现钙化及超早期出血较MR敏感,MR对血肿的分期敏感。CTA、MRA、DSA可见瘤巢、引入动脉影及引流静脉影,CTA、MRA分辨率不及DSA,DSA对动静脉畸形内部结构的显示不及CTA、MRA。影像学表现可以反映脑动静脉畸形的大体病理结构。结论不同的影像手段对动静脉畸形的诊断各具价值。

Objective To probe manifestations of cerebral arteriovenous malformation in imaging ofCT, MRI, CTA, MRA, DSA, a comparative analysis was conducted as well. Methods Data were from 75 paticnts with cerebral arteriovenous malformation. By referring to surgical pathology exams and DSA as a gold standard, manifestations of imaging by CT, MRI, CTA, MRA, and DSA were compared. Results The sensitivity for diagnosing cerebral arteriovenous malformation was 83.9% for CT and 96% for MR. respectively. CT images showed mass, honeycomb, nodules, and strands, and MR displayed flow-void signals resembling earthworm or strand. CT is more sensitive than MR. in finding out calcification and ultra-early bleeding, and MR is superior in grading the haematoma. CTA, MRA and DSA are able to show oarcinoma nest, inlet artery and outlet artery. CTA and MRA had a poorer resolution than DSA. DSA was inferior in showing inner strttcture to CTA and MRA. Manifestations of images ate able to reflect the general pathological structure of cerebral arteriovenous malformation. Conclusion The different image means vary in value for diagnosing cerebral arteriovenous inatformation, a combined use of them can achieve the goal for qualitatively diagnosi.ng cerebral arteriovenous inalformation.