CAJ | 학술논문

目的通过与脊髓DSA及手术对比,初步探讨256层MSCT全脊髓血管成像(CTA)及3.0TMR脊髓血管动态增强扫描(CE-MRA)诊断脊髓血管畸形的临床应用价值.方法 17例临床表现及MR平扫疑诊为脊髓血管病的患者,全部行CTA检查,其中10例行MRA检查,15例在CT或MR检查3～5d后行DSA检查,8例患者经手术治疗.将其CTA、MRA、DSA及手术结果进行对比.结果行CTA检查的17例患者中,16例较好地显示了异常血管病变的范围,其中7例诊断为硬脊膜动静脉瘘,7例为髓周动静脉瘘,2例为脊髓动静脉畸形,与DSA或手术诊断一致,1例无法做出诊断.其中12例准确判定供血动脉,12例准确显示瘘口位置.行MRA检查的10例患者中,7例准确诊断供血动脉及瘘口位置,与DSA或手术结果一致；其余3例DSA检查阴性.结论 256层MSCT全脊髓CTA及3.0T MR CE-MRA能安全、无创、快速、清晰地显示脊髓血管畸形的病变范围、供血动脉及瘘口的位置,缩短DSA诊疗时间,在脊髓血管畸形的诊断、协助制订治疗方案及术后随访方面起到重要作用.
목적 통과여척수DSA급수술대비,초보탐토256층MSCT전척수혈관성상(CTA)급3.0TMR척수혈관동태증강소묘(CE-MRA)진단척수혈관기형적림상응용개치.방법 17례림상표현급MR평소의진위척수혈관병적환자,전부행CTA검사,기중10례행MRA검사,15례재CT혹MR검사3～5d후행DSA검사,8례환자경수술치료.장기CTA、MRA、DSA급수술결과진행대비.결과행CTA검사적17례환자중,16례교호지현시료이상혈관병변적범위,기중7례진단위경척막 동정맥루,7례위수주동정맥루,2례위척수동정맥기형,여DSA혹수술진단일치,1례무법주출진단.기중12례준학판정공혈동맥,12례준학현시루구위치.행MRA검사적10례환자중,7례준학진단공혈동맥급루구위치,여DSA혹수술결과일치；기여3례DSA검사음성.결론 256층MSCT전척수CTA급3.0T MR CE-MRA능안전、무창、쾌속、청석지현시척수혈관기형적병변범위、공혈동맥급루구적위치,축단DSA진료시간,재척수혈관기형적진단、협조제정치료방안급술후수방방면기도중요작용.
Objective To explore the value of CT spinal angiography with 256 MSCT and fast dynamic contrast-enhanced 3D MR angiography (CE-MRA) at 3.0 T in the diagnosis of spinal vascular malformations by comparing with results of DSA and operation.Methods Seventeen patients suspected of spinal vascular diseases by initial MR and clinical manifestations all underwent CT spinal angiography.Of them,10 patients underwent MRA,15 patients underwent DSA within 3-5 days,and 8 patients finally underwent surgical treatment.Results CTA examination clearly showed the abnormal vascular lesions in 16 of 17 cases,including 7 cases with the diagnosis of spinal dural arteriovenous fistula,7 cases of perimedullary arteriovenous fistula,and 2 cases of spinal arteriovenous malformations. The results were consistent with the diagnosis of DSA or surgery.One case was poorly diagnosed.The feeding vessels were correctly determined in 12 cases,and the level of fistulas were correctly displayed in 12 cases.The level of fistulas and feeding vessels were accurately showed in 7 of 10 cases with MRA,while the other 3 cases exhibited normal with DSA.Conclusions Spinal angiography with 256 MSCT and CE-MRA at 3.0 T can clearly show the extent of spinal vascular malformations,feeding arteries and fistula location.They are safe,noninvasive,convinient and can shorten the time of DSA diagnosis and treatment.They play an important role in diagnosis and treatment of spinal vascular malformations and postoperative follow-up.