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目的探讨多层螺旋 CT 血管成像(CTA)在脊髓血管病变诊断中的价值。方法对MRI 及临床表现符合脊髓血管病的10例患者行 CTA。其中7例于1周内行 DSA 检查,4例行手术治疗。CT 扫描采用 Toshiba Aquilion 64层 CT 扫描机,采用多平面重组、曲面重组、最大密度投影、容积重组方法进行图像后处理。主要从分型、显示病变范围、供血动脉、瘘口及引流静脉等方面对 CTA 图像进行评价,并与 DSA 及手术结果对照。结果 10例患者 CTA 均显示了脊髓血管畸形;3例为髓内动静脉畸形,2例为髓周动静脉瘘,5例为硬脊膜动静脉瘘。所有病例均清楚显示病变范围及引流静脉,除1例患者有2根血管为假阳性,其余患者均清楚显示供血动脉并与 DSA 检查结果一致。结论 CTA 对脊髓血管病变的诊断有较大价值,可作为 DSA 检查前的筛选检查。
Objective To investigate the value of multislice CT angiography (CTA) in the diagnosis of spinal vascular lesions. Methods CTA was performed in 10 patients with MRI and clinical manifestations of spinal vascular disease. Among them, 7 cases underwent DSA examination within 1 week and 4 cases underwent surgical treatment. The CT scan was performed on a Toshiba Aquilion 64-slice CT scanner using post-processing with multiplanar reconstruction, surface recombination, maximum density projection, volumetric recombination. CTA images were mainly evaluated from the classification, the range of lesions, the feeding arteries, the fistula and the drainage veins. The results were compared with DSA and surgical results. Results CTA of all the 10 patients showed spinal vascular malformations, 3 cases of intramedullary arteriovenous malformations, 2 cases of medullary arteriovenous fistulas and 5 cases of spinal dural arteriovenous fistulas. All cases clearly showed the extent of the lesion and the drainage veins. Except for 1 case, 2 vessels were false positive, and the rest showed clearly the feeding artery and were consistent with the results of DSA. Conclusion CTA has great value in the diagnosis of spinal vascular lesions, which can be used as a screening test before DSA.