CTA与MRA在诊断脊髓血管畸形中的价值及其临床应用

Evaluation of the clinical value of 640-slice spiral CT angiography and 3.0T dynamic MR angiography in the diagnosis of spinal vascular malformations

目的:评价640层多层螺旋CT血管成像(CTA)与3.0T动态MR血管成像(CE-MRA)在诊断脊髓血管畸形中的临床应用价值。方法:19例临床怀疑脊髓血管病变的患者,其中11例行多层螺旋CTA检查,10例行CE-MRA检查,16例接受DSA治疗,3例接受手术治疗。结果 :11例行CTA检查中有4例为硬脊膜动静脉瘘(SDAVF),4例为髓周动静瘘(PMAVF),2例为脊髓动静脉畸形(SCAVF),8例与DSA诊断一致,1例DSA为阴性;10例行MRA检查中有7例为SDAVF,其中2例SDAVF CTA检查未显示供血动脉及瘘口,CE-MRA显示很好的供血动脉及瘘口,2例为PMAVF,1例为SCAVF,均与DSA诊断一致。结论:3.0T CE-MRA对显示脊髓血管畸形的供血动脉及瘘口,在诊断脊髓血管畸形中优于CTA;脊髓CTA对脊髓血管畸形的诊断有很大的价值,可作为DSA检查前的筛选检查,并对DSA有指导作用;而3.0T CE-MRA可快速、无创、清晰地显示脊髓血管畸形的供血动脉及瘘口;CTA、CE-MRA在诊断脊髓血管畸形、协助制定治疗方案及术后随访等方面具有重要价值。

Objective： To evaluate the clinical value of 640-slice spiral CT angiography（CTA） and 3.0T dynamic MR angiography（CE-MRA） in the diagnosis of spinal vascular malformations. Methods： Nineteen cases of clinically suspected spinal vascular disease patients, including 11 cases with CTA examinations, 10 patients with CE-MRA examination, 16 with DSA treatment and 3 with surgery were studied. Results： Four of the 11 cases with CTA examinations were SDAVF, 4 were PMAVF and 2 were SCAVF. Eight were consistent with the DSA diagnosis, and the DSA of one case was negative. Seven of the 10 cases with MRA examinations were SDAVF, in 2 of which CTA examinations did not display the artery and the fistula, but CE-MRA showed the artery and the fistula well. Two cases were PMAVF and 1 case was SCAVM, all consistent with the DSA diagnosis. Conclusion： 3.0T CE-MRA is better than CTA in displaying the spinal vascular malformations artery and fistula, and in diagnosing of spinal vascular malformations. CTA spinal angiography has a great value in the diagnosis of the spinal vascular malformations, and can be used as a screening examination prior to the DSA to guide the DSA. While 3.0T CE-MRA can display the spinal vascular malformations artery and fistula quickly, noninvasively and clearly. CTA and CE-MRA are of great value in diagnosing the spinal vascular malformations, in assisting determining the treatments and in the follow-up visits, etc.