112例脑动静脉畸形DSA分析

The DSA analysis of 112 cases of cerebral arteriovenous malformations

目的 :分析脑AVM的DSA特征 ,尤其是供血动脉的来源。方法 :回顾性分析 112例脑AVM的DSA图像 ,将供血动脉分为 :①隐匿型 ;②穿支供血 ;③终末供血三型 ,其中终末供血又分为a .颅内单干单支供血 ;b .颅内单干多支供血 ;c.颅内多干供血 ;d .颅内多系统供血 ;e .颅内和颅外共同供血 5种方式。对畸形血管团、引流静脉和其它伴随改变也进行了统计。结果 :①隐匿型、穿支供血、终末供血各型分别为 2例 (1.8% ) ,2例 (1.8% ) ,10 8例 (96 .4 % ) ,其中a、b、c、d、e各型分别为 2 9例 (2 5 .9% ) ,2 1例 (18.8% ) ,16例 (14 .3% ) ,35例 (31.32 % ) ,7例 (6 .3% ) ;②畸形血管团 :幕上 92例 (82 .1% ) ,幕下 2 0例 (17.9% ) ;③引流静脉中 10 2例 (91.1% )引流入浅静脉及硬膜窦 ,4例 (3.6 % )引流入深静脉 ,6例 (5 .4 % )为混合引流。结论 :这种供血动脉分类方法能反映脑AVM的供血特点 ,脑AVM的血供比较复杂。

Objective:To analyze the DSA characteristics of cerebral arteriovenous malformations (AVM),especially the source of feeding arteries.Methods:The DSA image of 112 cases of cerebral AVM were analyzed retrospectively and the feeding arteries were classify into three types:①occult type;②perforating branch arterial type;③terminal arterial type. 5 kinds of feeding styles were differentiated within the terminal arterial type which were: a. intracranial single stem single branch; b. intracranial single stem multiple branches;c. intracranial multiple stems;d. intracranial multiple systems; e. extracranial and intracranial arteries feeding together,respectively.The nidus and drainage vein were also analyzed.Results:①occult type, perforating branch aterial type, terminal arterial type can be seen in 2 cases (1.8%), 2 cases (1.8%), 108 cases (96.4%) respectively.There are 29 cases (25.9%), 21 cases (18.8%), 16 cases (14.3%), 35 cases (31.3%),7 cases (6.3%) in each styles of a, b, c, d and e.② 92 cases (82.1%)was located above the tentorium of cerebellum, the other 20 cases (17.9%)was located beneath the tentorium of cerebellum. ③ in 102 cases(91.1%)the drainage vein join in the superficial vein and dural sinuses. Another 4 cases (3.6%) were drained into deep vein, 6 cases (5.4%) were drained to both ways.Conclusion:This kind of classification can reflect the characteristics of cerebral AVM,it also indicates that the feeding arteries is complex.