脑发育性静脉畸形影像表现分析

Cerebral Developmental Venous Anomalies: Analysis 9 Cases and Literature Review

目的:研究脑发育性静脉畸形(CDVA)临床及影像学特征并进行文献复习。方法:回顾性分析2011年11月—2014年3月确诊的9例CDVA患者,对其临床特征、影像学检查方法包括电子计算机断层扫描(CT)、核磁共振成像(MRI)、数字减影血管造影(DSA)及特征进行分析并对相关文献进行复习。结果:9例患者中头晕4例(4/9)、头痛4例(4/9)、恶心不适2例(2/9)、站立不稳1例((1/9)、小脑出血史1例(1/9),眼部症状行眼科检查偶然发现小脑CDVA 1例(1/9)。病变部位:病变位于幕上4例(4/9),幕下5例(5/9)。影像学特点:CT增强及重建、MRI的T1W1增强、SWI,MRA及DSA静脉期像均可显示出髓静脉及其形成的特征性"海蛇头"征象和其引流静脉。结论:CT,MRI,DSA影像学方法均可用于CDVA的诊断,在临床实践中需根据需要优化选择联合应用。

Objective： To study the clinical and imaging features of cerebral developmental venous anomalies（ CDVA）and review the literatures. Method： Nine cases of CDVA were retrospectively collected from November,2011 to March,2014.The clinical features and the imaging examination,computed tomography（ CT）,magnetic resonance imaging（ MRI） and digital subtraction angiography（ DSA）,were anlyzed and the related literatures were reviewed. Results： Symptoms： Of 9 cases,4 cases with dizzy（ 4 /9）,4 cases with headache（ 4 /9）,2 cases with nausea（ 2 /9）,1 case with astasia（ 1 /9）. 1 case with history of cerebellum hemorrhage,1 case with fortuitous findings by ophthalmologic examination（ 1 /9）. Location： Of 9 cases,4 cases with supratentorial lesion（ 4 /9）,5 cases with infratentorial lesion（ 5 /9）. Imaging features： The dilated medullary veins（ forming a typical caput medusae sign） and collector veins can be showed contrast- enhancement CT,reconstruction techniques,contrast- enhancement MRI,SWI image and venous phase DSA. Conclusion： The imaging modalities including CT,MRI and DSA can be employed for the diagnosis of CDVA. But the combination and optimal choice of these modalities for different cases is important to clinical practice.