脊髓动静脉畸形的MRI诊断及鉴别诊断

MRI diagnosis and differential diagnosis of spinal arteriovenous malformations

目的探讨脊髓动静脉畸形的MRI表现及鉴别诊断要点。方法回顾性分析我院12例脊髓动静脉畸形患者的临床和MRI资料,并总结其MRI表现。结果 12例患者病变均位于胸段。8例MRI表现为脊髓背侧或/和腹侧蛛网膜下隙内可见串珠状、蚯蚓状扭曲血管流空影,髓内见广泛的异常信号,T1WI呈等或稍低信号,T2WI呈高信号;3例脊髓内见范围长度不等的迂曲状畸形血管样流空影,增粗的血管呈蚯蚓状、蜂窝状,脊髓伴有空洞或囊状扩张等改变;1例脊髓内及脊髓背侧或/和腹侧蛛网膜下隙内可见迂曲状畸形血管流空影,髓内可见较广泛水肿。其中2例经DSA证实为脊髓动静脉畸形,行DSA栓塞术后好转。结论脊髓动静脉畸形MRI表现有一定特征性,MRI对诊断脊髓动静脉畸形具有较大价值。

Objective To analyze the magnetic resonance imaging （MRI） features and differential diagnosis of spinal arteriovenous malformations. Methods MRI and clinical data of 12 patients with spinal arteriovenous malformations were ana-lyzed retrospectively, summarized their MRI features. Results Of the 12 cases, all the lesions were located in the thoracic spinal cord. 8 cases presented as extensive abnormal signal in the spinal cord, the MR signal intensity of the spinal cord lesions presenting as isointensity or slight hypointensity on T1 weighted images and hyperintensity on T2 weighted images, bead-like, lumbricoid tortuosity vessels could be found in the spinal cord dorsal or the ventral subarachnoid space. For 3 cases , length ranged circuity of abnormal blood vessels situated in the spinal cord and with hollow or cystic expansion. 1 case showed edema of the spinal cord, and the dilated and tortuous spinal vessels in the spinal cord dorsal or the ventral subarachnoid space. Among them 2 cases confirmed by DSA, and improved after DSA embolization. Conclusion Spinal arteriovenous malformations have specific characteristics in MR imaging, MRI has great value in the diagnosis of spinal arteriovenous malformations.