脑动静脉畸形的比较影像学初步研究

Primary Study of Comparative Imageology in Arteriovenous Malformation of Brain

目的 评价多种影像学检查对脑AVM的诊断价值和限度,探讨优选检查路线。方法 搜集脑动静脉畸形(AVMB)54例,全部行CT、MR和X线脑血管造影检查,部分行经颅多普勒超声(TCD)检查。全组病例均行介入栓塞或手术切除治疗,确证AVMB的诊断。结果 CT诊断AVMB的敏感度为4068%,而MR与X线脑血管造影检查均为100%,后者在反映AVMB的循环时间、“盗血”情况和同时实施介入治疗等方面是其他检查方法不可替代的。TCD显示患者的脑血流速度加快。结论 CT和TCD对AVMB的诊断价值有限,前者仅用于合并颅内出血时,后者主要用于术中和术后脑血流的监测。MR可确定AVMB的诊断,但是若行介入治疗,仍需实施X线脑血管造影检查。

Objective To evaluate the value and limit of several imaging modalities and probe into the optimal examination route of arteriovenous malformation of brain(AVMB). Methods 54 patients with AVMB were collected,and examined by CT,MR and X ray cerebral angiography in all,and by TCD in part of them.The interventional therapy and surgical resection were performed in all patients and the diagnosis of AVMB was corroborated. Results The diagnostic sensitivity of CT was 40 68%,but they were 100% of MR and X ray cerebral angiography,and the latter could reflect circulatory time,depict the 'steal flow' phenomenon of AVMB,and perform the interventional therapy,and so on,and not be replaced by other moalities.The transcranial Doppler (TCD) could demonstrate the speed of cerebral blood flow increasing in patients with AVMV. Conclusion The diagnostic value of CT and TCD are limited,the former only used in combining intracranial hemorrhage,the latter is suitable for intraoperative and postoperative monitoring cerebral blood flow.The MR can make the diagnosis of AVMB,But X ray cerebral angiography is necessary when interventional therapy should be performed. [