64排螺旋CT血管造影对脑动静脉畸形的诊断价值

Value of 64-slice spiral CT angiography in diagnosing cerebral arteriovenous malformations

目的探讨64排螺旋CT血管造影(CTA)在脑动静脉畸形(AVM)诊断中的价值。方法回顾15例经手术或DSA证实的AVM患者,术前15例患者均行64排螺旋CT血管造影。均采用GE64排Light speed VCT获得原始图像,然后在工作站中进行多层面重建(multiplanar reconstruction,MPR)、容积再现(volume rendering,VR)、薄层块最大密度投影(thin-slab maximum intensity projectjon,TSMIP)。结果 15例AVM患者的CTA断面和重建图像均显示大小不等的畸形血管团。13例发现供血动脉(86.7%),2例未见显示,15例均见明确的引流静脉或扩大的静脉窦(100%),单支动脉供血11例,其中大脑前动脉2例,大脑中动脉5例,大脑后动脉3例,后交通动脉1例,多支动脉供血2例。引流静脉汇入上矢状窦6例,直窦、乙状窦分别3例,上矢状窦和乙状窦1例,窦汇1例,上矢状窦、横窦和岩上窦1例。其中1例合并动脉瘤。结论 64排螺旋CTA在脑动静脉畸形(AVM)诊断中有十分重要的价值,为临床治疗方案的制定及术后随访提供依据,可作为脑动静脉畸形(AVM)的术前主要检查方法。

Objective: To explore the value of 64-slice spiral CT angiography in diagnosis of cerebral arteriovenous malformations( AVM). Methods: Fifteen cases suspected cerebral AVM received CT scan and digital subtraction angiography( DSA)or operation,and the results were compared retrospectively. Source images were got by GE light speed VCT scanner and were performed to reconstruct by MPR,VR,TSMIP. Results: Fifteen cases all demonstrated malformed vessel nests and draining veins( 100%),but the feeding arteries of two cases were missed( 86. 7%). Eleven cases had single feeding artery and two cases had multifeeding arteries. The feeding artery originated from the middle cerebral artery in five cases,the posterior cerebral artery in three cases,the anterior cerebral artery in two cases,the posterior communicating artery in one case. The draining veins entered the superior sagittal sinus in six cases,the straight sinus in three cases,the sigmoid sinus in three cases,the superior sagittal sinus and sigmoid sinus in one case,the confluence in one case,the superior sagittal sinus 、transverse sinus and superior petrous sinus in one case. One case had aneurysms. Conclusion: 64-slice spiral CTA is playing an important role in the diagnosis of cerebral AVM and is also useful for therapeutic planning and postoperative follow-up. CTA is the main tool in the preoperational diagnosis of AVM.