CTA在颅内动静脉畸形诊治中的应用

THE APPLICATION OF SUBTRACTION CTA ON DIAGNOSIS AND TREATMENT OF INTRACRANIAL ARTERIOVENOUS MALFORMATIONS

目的:探讨减影CTA在颅内动静脉畸形诊治中的应用价值。方法:DSA诊断为颅内动静脉畸形32例。经64层螺旋CT平扫、增强动脉期和静脉期扫描。将动脉期数据减去平扫数据获得动脉的减影数据,静脉期数据减去动脉期数据获得静脉减影数据,静脉期数据减去平扫数据获得混合动静脉的减影数据。采用容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)进行颅内动静脉畸形三维成像。结果:本组颅内动静脉畸形幕上30例,幕下2例。其中额叶动静脉畸形6例,顶叶动静脉畸形5例,枕叶动静脉畸形4例,顶枕部动静脉畸形4例,侧裂区3例,额顶区动静脉畸形2例,颞顶区动静脉畸形2例,颞叶动静脉畸形2例,胼胝体动静脉畸形1例,丘脑动静脉畸形1例,小脑半球动静脉畸形1例,脑干动静脉畸形1例。单一供血动脉供血8例,两支及以上动脉供血14例;其中浅表静脉回流引流29例,深静脉回流引流3例。结论:减影CTA能够清楚显示供血动脉的来源、数目和形态,以及引流静脉的部位、大小以及深度。对临床诊断及手术方案的制定具有重要的指导作用。

Objective：To investigate the application of subtraction CTA on diagnosis and treatment of intracranial arteriovenous malformations.Methods：The diagnosis of intracranial arteriovenous malformation was confirmed by DSA in 32 cases.The data obtained by 64-slice spiral CT scan,enhanced arterial phase and venous phase scan were converted through computer into the artery subtraction data,intraveuous subtraction data,and mixed arteriovenous sub traotion data.Then VR,MIP and MPR were used to construct three-dimensional imaging of intracranial malformation. Results：Intracranial arteriovenous malformation included supra-tentorial 30 cases and sub-tentorial 2 cases;with single feeding artery in 8 cases,more than two in 24 cases,with superficial venousdrainage in 29 cases,deep venous drainage in 3 cases. Conclusion：Subtracted CTA can clearly show the source, number and morphology of veeding arteries,as well as the site,size and depth of venous drainage,and play an important guiding role in clinical diagnosis and surgical programs.