脊髓血管畸形的DSA检查与栓塞治疗

DSA Examination and Embolization Therapy of Spinal Vascular Malformations

目的 探讨脊髓血管畸形的DSA检查与栓塞治疗。资料与方法 搜集脊髓血管畸形 9例 ,临床均表现为进行性脊髓损害。经股动脉穿刺插管 ,对每一对肋间动脉和腰动脉进行造影 ,颈髓血管畸形者行双侧椎动脉、甲颈干及肋颈干造影。 9例中 ,单纯栓塞 6例 ,单纯手术 2例 ,未治 1例。结果 选择性脊髓血管DSA的病变显示率达 10 0 %。栓塞治疗的 6例 ,临床症状均有明显改善。结论 选择性脊髓血管DSA是诊断脊髓血管畸形的可靠依据。栓塞治疗操作简便 ,创伤性小 ,并发症少 。

Objective To evaluate DSA examination and embolization treatment of spinal vascular malformations in clinical practice.Materials and Methods This study included 9 patients with spinal vascular malformations. Clinically, all patients showed signs of slowly progressing impairment of spinal cord. Using Seldinger technique, angiography of each pair of intercostals and lumbar arteries was carried out. For patients with suspected cervical vascular malformations, angiography of bilateral vertebral arteries, and bilateral thyrocervical and costocervical trunks was performed. Six cases were treated with embolization only, while 2 with surgery only. The remaining one received no treatment. Results The displaying rate of the lesions on selective myeloangiographs with DSA was 100%. Obvious improvement in clinical symptoms was seen in the 6 patients receiving embolization treatment.Conclusion Selective myeloangiography with DSA is a reliable technique for the diagnosis of spinal vascular malformations. Embolization is a simple and minor invasive procedure with less complication, therefore, it is an ideal therapy for spinal vascular malformations.