脑动静脉畸形出血的血管构筑学因素探讨

Angio-architectural factors related to cerebral arteriovenous malformations hemorrhage

目的:探讨脑动静脉畸形(AVM)的相关血管构筑学因素与出血的关系,以期预测脑AVM出血的危险性。方法:采用数字减影血管造影(DSA)为200例脑AVM患者进行全脑血管造影,分析脑AVM的供血动脉、畸形血管团和引流静脉等的情况,比较不同血管构筑的AVM患者出血的比率。结果:穿支动脉供血、小病灶、位于基底节和后颅窝、单支静脉引流、深部引流、有静脉狭窄或闭塞及伴发动脉瘤者易出血。结论:与脑AVM出血密切相关的危险因素是供血动脉的类型、AVM的大小和部位、引流静脉的数目、引流静脉的类型和有无狭窄或闭塞、是否合并动脉瘤。

Objective： To explore the relationship between angio-architectures of cerebral arteriovenous malformations（AVM） and hemorrhage and to reveal the risks of bleeding. Methods： Aortocranial angiography was taken for 200 patients by digital subtraction angiography （DSA）, and then the feeding artery of AVM, the malformation vessel corps, and the draining veins were searched. Bleeding ratios of patients with different anglo-architectures were compared. Results： AVMs fed by perforators, located in the basal ganglia and post-cranial fossa, with small size, exclusively deep drainage, venous stenoses and complicated aneurysms were more likely to present with hemorrhage. Conclusion： The hemorrhage of AVM is significantly concerned with many factors, such as the type of feeding artery, size and location of the AVM, the draining vein and sometimes complicated aneurysms.