椎管内血管性病变的影像学诊断特征

Image features of vascular malformations and angioma of spinal cord

目的 :探讨椎管内血管性病变的影像学特点。 方法 :40例椎管内血管性病变包括髓内动静脉畸形 (AVM) 13例、硬脊膜动静脉瘘 (SDAVF) 14例、硬膜下髓周动静脉瘘 (AVF) 9例、海绵状血管瘤 3例和血管母细胞瘤 1例 ,均行 MRI检查和数字减影血管造影 (DSA)检查 ,并行栓塞或手术治疗。结果 :MRI对于多数髓内 AVM、SDAVF和髓周 AVF均能显示病变部的异常血管 ,海绵状血管瘤为混杂信号影或兼有周围环状低信号影 ,血管母细胞瘤可表现为髓内强化明显的实质性团块状影和异常血管影。 DSA检查可以显示髓内 AVM、SDAVF和髓周 AVF的畸形血管团或瘘口 ,以及供血动脉和引流静脉 ;海绵状血管瘤不显影 ,血管母细胞瘤的瘤体和供血动脉均可以显影。 结论 :DSA检查是具有确定意义的检查 。

Objective: To determine the image features of vascular malformations and angioma of spinal cord. Methods: Forty patients including intramedullary arteriovenous malformations (AVM) 13 cases, spinal dural arteriovenous fistulae(SDAVF) 14 cases, intrathecal perimedullary arteriovenous fistulae (AVF) 9 cases, cavernomas 3 case and hemangioblastoma 1 case in spinal cord were studied. All patients had received both MRI and digital subtraction angiography (DSA) examination and finally received surgery or embolization. Results: MRI examination showed that vascular malformations or vein could be seen in the image of AVM, SDAVF and AVF. Mix signal and low surround signal could be seen in the image of cavernomas. Local phymatoid signal which enhanced apparently could be seen in the image of hemangioblastoma. DSA examination showed that the nidus or fistula,supplying artery and drainage vein of AVM, SDAVF and AVF could be seen.Aneurysmal lesion and supplying artery could be seen in human gioblastoma but obscured in cavernomas. Conclusion: Spinal angiography(DSA) is determination examination for these lesions. MRI plays an important role for determining the localization.