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目的 评估三维CT血管造影 (3D CTA)在脑动静脉畸形诊断及术前评估中的应用。方法 对我科收治的 2 5例脑动静脉畸形患者采用 3D CTA检查 ,并同期行脑数字减影血管造影(DSA) ,比较两种检查的结果。结果 3D CTA显示了 2 4例动静脉畸形 ,3D CTA在显示畸形血管团、供血动脉和引流静脉的三维构造以及空间关系上优于DSA ,并能显示三者与颅骨的关系。 3D CTA虽未能发现 1例小型小脑动静脉畸形 ,但其显示了一个位于小脑后下动脉 (PICA)远端的供血动脉动脉瘤 ,并确定了出血系动脉瘤而非动静脉畸形。 3D CTA可以模拟手术入路时可观察到的血管构造 ,有助于正确判断动静脉畸形的各种成分 ,提高手术的安全性。结论 3D CTA对脑动静脉畸形的诊断及其术前评估有其独特的价值。尤其适合于大型脑动静脉畸形、动静脉畸形合并动脉瘤以及颅内巨大血肿怀疑系动静脉畸形破裂者。它与DSA可互补 ,但尚无法取代DSA。
Objective To evaluate the application of three dimensional CT angiography (3D CTA) in the diagnosis and preoperative evaluation of cerebral arteriovenous malformations. Methods Twenty-five patients with cerebral arteriovenous malformation admitted to our department were examined by 3D CTA, and brain digital subtraction angiography (DSA) was performed in the same period. The results of the two examinations were compared. Results 3D CTA showed 24 cases of arteriovenous malformations. 3D CTA was superior to DSA in displaying the three-dimensional structure and spatial relationship of abnormal blood vessels, feeding arteries and drainage veins, and showing the relationship between the three and skull. The 3D CTA, although not able to detect 1 small cerebellar arteriovenous malformation, showed a donor artery aneurysm distal to the inferior cerebellar posterior artery (PICA) and identified hemorrhagic aneurysms instead of arteriovenous malformations. 3D CTA can simulate the vascular structure observed when the surgical approach, to help correctly determine the various components of arteriovenous malformations, improve surgical safety. Conclusion 3D CTA has unique value in the diagnosis and preoperative evaluation of cerebral arteriovenous malformations. Especially suitable for large cerebral arteriovenous malformations, arteriovenous malformations with aneurysms and intracranial giant hematoma suspected Department of arteriovenous malformations were broken. It is complementary to DSA, but it can not replace DSA.