脑动静脉畸形的螺旋CT血管造影诊断

Spiral CT Angiography of Cerebral Arteriovenous Malformation

目的 探讨螺旋CT血管造影 (SCTA)对脑动静脉畸形 (AVM )的诊断价值。方法 2 6例脑AVM行SCTA ,准直器宽度 1.0～ 2 .0mm ,层间距 1.0mm ,SCTA均与DSA对照。结果 2 6例脑AVM共有瘤巢 2 6个、供血动脉 3 6根、引流静脉 3 7根。SCTA显示瘤巢 2 4个 (92 .3 % ) ,SCTA显示的瘤巢大小与DSA一致 2 2个 (84.6% ) ,对纤细畸形血管显示能力不高是SC TA漏诊瘤巢及显示的瘤巢小于DSA的原因 ;SCTA显示供血动脉 3 1根 (86.1% )、引流静脉 3 3根 (89.2 % ) ,漏诊的供血动脉和引流静脉均分流量小、血管细 ;4例AVM用多层螺旋CT行SCTA显示了全部病变。结论 SCTA对脑AVM有较高的诊断准确性 ,可指导治疗及随访疗效 ,应用多层螺旋CT行SCTA覆盖范围大、空间分辨力高。

Objective To investigate the diagnostic value of spiral CT angiography (SCTA) of cerebral arteriovenous malformation (AVM). Methods Twenty six cases of cerebral AVM underwent SCTA.The collimation was 1.0-2.0mm and index 1.0mm.Each case of SCTA was compared with DSA. Results The 26 cerebral AVM had 26 nidi,36 feeding arteries and 37 draining veins overall.SCTA demonstrated 24 nidi (92.3%) and among them 22 (84.6%) were the same size as DSA.SCTA couldn't show the fine deformed vessels due to limited space resolution,which was the reason that SCTA misdiagnosed some AVM nidi and some nidi which SCTA showed were smaller than those in DSA.SCTA demonstrated 31 feeding ateries (86.1%) and 33 draining veins (89.2%) and all the misdiagnosed feeding arteries and draining veins were thin vessles. In 4 cases of cerebral AVM examined by multi slice spiral CT,SCTA demonstrated all the nidi,feeding arteries and draining veins. Conclusion SCTA has a high accuracy in diagnosing the cerebral AVM and can direct the treatment and follow up the treatment effects.SCTA using multi slice spiral CT can examine wider range of brain and has higher space resolution.