MSCTA评价颌面部动静脉畸形内血管结构的价值

MSCTA in assessing the vascular structure of arteriovenous malformation in the maxillofacial region

目的:探讨多层螺旋CT血管成像(MSCTA)对评价颌面部动静脉畸形(AVM)内血管结构的临床诊断价值。方法:对照DSA诊断结果,回顾性地分析48例AVM患者的MSCTA原始图像以及容积再现(VR)和最大密度投影(MIP)的影像表现。观察内容包括畸形血管团的数目和部位、供血动脉和引流静脉的数目和方向等。结果:MSCTA对畸形血管团的检出率为100%,对供血动脉的检出率为89.6%(43/48),对引流静脉的检出率为91.7%(44/48)。其中对1、2级供血动脉的检出率为81.4%(35/43),供血动脉和引流静脉均被检出者为42例(87.5%)。根据病变的供血动脉和引流静脉数目,将42例病人分为3型:单纯型(14例)、单多吻合型(16例)和复杂型(12例),CTA对3种类型AVM的诊断符合率分别为88.10%、90.48%和90.48%。根据病变的供血动脉和引流静脉的方向分为同侧吻合(25例)和双侧吻合(17例),CTA对两者的诊断准确率均为97.62%。结论:MSCTA能显示大多数颌面部AVM内的血管结构,有助于临床治疗方案的制订。

Objective：The aim of this study was to explore the value of multi-slice computed tomography（MSCTA） in analyzing the vascular structure of arteriovenous malformation（AVM） in the head and maxillofacial region.Methods：Forty-eight patients with AVM of head and maxillofacial region,confirmed by DSA,were retrospectively reviewed for MSCTA original images,volume rendering（VR） and maximum intensity projection（MIP） images.Observational items included the number,location,division and direction of malformed vascular（feeding arteries and draining veins）.Results：Comparing with DSA manifestions,malformed blood vessels within AVM were shown in all patients（100%） on MSCTA images.The draining veins and feeding arteries were visible in 91.7%（44/48） and 89.6%（43/48）,respectively.The first and second divisions of feeding arteries were shown in 81.4%（35/43）.The draining veins and feeding arteries were visible in 87.5%（42/48） simultaneously.These 42 patients were classified into three types based on the number of the feeding arteries and draining veins：simple type（14 cases）,single-multi anastomoses type（16 cases） and complex type（12 cases）,and the accuracy in the diagnosis of three types reached to 88.10%,90.48% and 90.48%,respectively.These 42 patients were classified into two types based on the direction of the feeding arteries and draining veins：homolateral and bilateral anastomoses type,and the accuracy in the diagnosis of two types both reached to 97.62%.Conclusion：MSCTA can clearly reveal most abnormal structures within the maxillofacial AVM,which is useful for physicians to select clinical managements.