脊髓硬脊膜动静脉瘘1例

A Case Report of Spinal Dural Arteriovenous Fistula

目的:探讨脊髓硬脊膜动静脉瘘(spinal dural arteriovenous fistula, SDAVF)的临床和影像学特点,提高对该病的诊断能力。方法:报道1例经磁共振和血管造影的SDAVF病例,并复习相关文献。结果:SDAVF表现为不同程度的脊髓损害症状,临床缺乏鲜明的特点,易误诊,磁共振平扫及增强检查通常可以发现长节段脊髓病变及脊髓表面迂曲的扩张静脉,数字减影血管成像(DSA)是确诊的金标准,并可以发现瘘口位置;早期治疗能够改善预后。结论:提高对SDAVF的警惕性,认识该病临床表现的复杂多变,提高该病的影像学识别能力是正确诊断的关键。

Objective: To investigate the clinical and imaging features of spinal dural arteriovenous fistula (SDAVF) and improve the diagnostic ability of SDAVF. Methods: A case of SDAVF by MRI and angi-ography was reported, and the related literature was reviewed. Results: SDAVF showed different degrees of spinal cord injury symptoms, lacking distinct clinical features and easy to be misdiag-nosed. Plain and enhanced MRI can usually find long segment spinal cord lesions and tortuous di-lated veins on the surface of the spinal cord. Digital subtraction angiography (DSA) is the gold standard for diagnosis, and can find the location of fistula;early treatment can improve the progno-sis. Conclusion: The key to correct diagnosis of SDAVF is to enhance the vigilance of SDAVF, recognize the complexity and variability of its clinical manifestations, and improve its imaging recognition ability.