CAJ | 학술논문

目的探究脑海绵状血管畸形(CMs)与动静脉畸形(AVMs)的结构差异和对于放射外科治疗反应的不同.方法实验样本共33例,包括放射外科治疗后的CMs 3例,放射外科治疗后的AVMs 3例,未经照射的CMs 6例,未经照射的AVMs 17例和健康对照4例.取材后立即处理,并应用光学显微镜和透射电子显微镜观察5组间的超微结构差异.结果 CMs显示管腔直径与血管壁的厚度较大而且缺乏内皮下成纤维细胞,肌成纤维细胞和平滑肌细胞.CMs放射外科治疗后形成部分蛋白质凝块(管腔的19％～22％),在放射治疗后长达6年后也未出现完整的血管闭塞.AVMs观察到由纤维蛋白血栓组成永久性的血栓,使血管完整的闭塞(管腔的91％～ 98％).照射诱导病灶周围的脑组织发生神经元丢失和神经原纤维变性.结论 CMs与AVMs的血管结构及细胞成分的不同导致它们对放射外科治疗的反应不同.
목적 탐구뇌해면상혈관기형(CMs)여동정맥기형(AVMs)적결구차이화대우방사외과치료반응적불동.방법 실험양본공33례,포괄방사외과치료후적CMs 3례,방사외과치료후적AVMs 3례,미경조사적CMs 6례,미경조사적AVMs 17례화건강대조4례.취재후립즉처리,병응용광학현미경화투사전자현미경관찰5조간적초미결구차이.결과 CMs현시관강직경여혈관벽적후도교대이차결핍내피하성섬유세포,기성섬유세포화평활기세포.CMs방사외과치료후형성부분단백질응괴(관강적19％～22％),재방사치료후장체6년후야미출현완정적혈관폐새.AVMs관찰도유섬유단백혈전조성영구성적혈전,사혈관완정적폐새(관강적91％～ 98％).조사유도병조주위적뇌조직발생신경원주실화신경원섬유변성.결론 CMs여AVMs적혈관결구급세포성분적불동도치타문대방사외과치료적반응불동.
Objective To study different vascular structure between cavernous malformations (CMs) and arteriovenous malformations(AVMs) and different changes of CMs and AVMs after radiosurgery.Methods 33 specimens,among them three irradiated CMs,three postradiation AVMs,six nonirradiated CMs,seventeen nonirradiated AVMs,and four normal controls were processed for ultrastructural study immediately after removal.Results compared with AVMs,CMs showed a higher ratio of intraluminal diameter to vessel wall thickness and a lack of subendothelial fibroblasts,myofibroblasts and smooth muscle cells.Partial proteinaceous clots(19％-22％ of lumen) formed in CMs sinusoids after radiosurgery but complete vaso-occlusion did not occur for up to 6 years after radiosurgery.In contrast,complete vaso-occlusion(91％-98％ of lumen) by fibrin thrombi that are permanent clots was observed in AVMs vessels.Radiation-induced neuronal loss,neurofibrillary degeneration of neurons and myelin fragmentation were typical in the surrounding brain tissue of the irradiated lesions.Conclusion The different structure and cellular compositions of CMs and AVMs are likely to influence their responses to radiosurgery.