CAJ | 학술논문

目的：探讨64排螺旋CT血管成像（CTA）在脑动静脉畸形（AVM）术前评价的应用价值。方法43例脑AVM术前均已完善CTA及数字减影血管造影（DSA）检查，参照Spetzler-Martin分级法，由放射科医师与神经外科医师共同阅片，以DSA为标准，应用CTA及DSA对其进行术前评价对比。结果43例脑AVM均为单发；并发颅内出血急诊入院的25例（58%）。CTA与DSA对比，对脑AVM的分级结果一致，43例脑AVM中Ⅰ级2例（4%），Ⅱ级5例（12%），Ⅲ级21例（49%），Ⅳ级11例（26%），Ⅴ级4例（9%）。 CTA与DSA对比，对脑AVM大小及引流静脉的检出结果一致，43例脑AVM中小型（<3 cm）7例，中型（3～6 cm）30例，大型（＞6 cm）6例，引流静脉共检出71条。43例脑AVM中，应用DSA检出供血动脉共73条，敏感度和准确度均为100%，应用CTA检出供血动脉共65条，CTA对供血动脉的检出敏感度和准确度分别为89%、100%。结论应用CTA与DSA对脑AVM术前评价结果差异无统计学意义（P＞0.05），CTA更为安全、方便，可作为首选方法。
목적：탐토64배라선CT혈관성상（CTA）재뇌동정맥기형（AVM）술전평개적응용개치。방법43례뇌AVM술전균이완선CTA급수자감영혈관조영（DSA）검사，삼조Spetzler-Martin분급법，유방사과의사여신경외과의사공동열편，이DSA위표준，응용CTA급DSA대기진행술전평개대비。결과43례뇌AVM균위단발；병발로내출혈급진입원적25례（58%）。CTA여DSA대비，대뇌AVM적분급결과일치，43례뇌AVM중Ⅰ급2례（4%），Ⅱ급5례（12%），Ⅲ급21례（49%），Ⅳ급11례（26%），Ⅴ급4례（9%）。 CTA여DSA대비，대뇌AVM대소급인류정맥적검출결과일치，43례뇌AVM중소형（<3 cm）7례，중형（3～6 cm）30례，대형（＞6 cm）6례，인류정맥공검출71조。43례뇌AVM중，응용DSA검출공혈동맥공73조，민감도화준학도균위100%，응용CTA검출공혈동맥공65조，CTA대공혈동맥적검출민감도화준학도분별위89%、100%。결론응용CTA여DSA대뇌AVM술전평개결과차이무통계학의의（P＞0.05），CTA경위안전、방편，가작위수선방법。
Objective To study the value of 64-row spiral CT augiography (CTA) in preoperative evaluation of brain arteriovenous malformation (AVM). Methods Reference Spetzler-Martin classification method of 43 cases of brain AVM preoperative grading, preoperative both improve the CTA and DSA examination, read together by radiologists and neurosurgeons, standard in order to the DSA examination that contrast the CTA and DSA examination in preoperative evaluation of brain AVM. Results Forty-three cases of brain AVM were single; Complicated intracranial hemorrhage emergency admission of 25 cases (58%). Make a same result with the CTA and DSA examination in brain AVM preoperative grading, 43 cases of brain AVM Ⅰ level 2(4%), Ⅱ level 5 cases(12%), Ⅲ level 21 cases(49%), Ⅳlevel 11 cases (26%), Ⅴ level 4 cases (9%). CTA and DSA, the size of cerebral AVM and venous drainage of the detection results, 43 cases of cerebral AVM small to medium size (<3 cm) in 7 cases, medium (3~6 cm), 30 cases of large (>6 cm) 6 cases, venous drainage were checked out 71. Forty-three cases of cerebral AVM, the application of blood supply artery DSA detected a total of 73, the sensitivity and accuracy were 100%, application of CTA detected blood supply artery 65, CTA detection sensitivity and accuracy of the blood supply artery were 89%, 100% respectively. Conclusion Application of CTA and DSA of cerebral AVM preoperative evaluation results no significant difference (P>0.05), the CTA is more safe and convenient that can be used as the preferred way.