硬脊膜动静脉瘘临床与影像分析(2)
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综上所述, SDAVF是一种少见病, 临床症状主要表现为脊髓功能受损。该病的初步诊断要靠脊髓MRI, DSA是确诊的金标准。由于自然病程预后不良, 须提高对此病的认识, 及早诊断, 是提高SDAVF的治疗效果的关键。
例1(图1-2)MRI示T5~11椎体水平多发迂曲血管影, 脊髓增粗水肿。DSA示供血动脉来自左侧胸6椎体下缘左侧肋间后动脉之脊髓根动脉分支, 该动脉迂曲向上方走行, 瘘口位于T5椎体上缘水平硬脊膜处, 椎管内引流静脉早显, 迂曲扩张, 向下引流。
例2 (图3-4)MRI示C2~3椎体水平颈髓前缘增粗血管影, 颈髓增粗水肿。DSA示左锁骨下动脉甲状颈干上行分支与脊髓静脉异常吻合, 椎管内引流静脉早显, 迂曲扩张, 向上方引流。
参考文献
[1]Koch C. Spinal dural arteriovenous fistula.Curr Opin Neurol, 2006, 19:69-75.
[2]Mascalchi M, Mangiafico S, Marin E. Hematomyelia complicating a spinal dural arteriovenous fistula.Report of a case. J Neuroradiol, 1998, 25:140-143.
[3]Jellema K, Canta LR, Tijssen CC, et al. Spinal dural arteriovenous fistulas:clinical features in 80 patients. J Neurol Neurosurg Psychiatry, 2003,74(10):1438-1440.
[4]张林,傅莉,卢春燕,等.脊髓硬脊膜动静脉瘘误诊误治1例分析.中国误诊学杂志, 2010,10(3):613-614.
[5]Sheikh SI,Busl KM. Ning M, et al. Spinal dural arteriovenous fistula mimicking prostate hyperplasia. J Emerg Med, 2011,41(6):137-140.
[6]Weber J, Thron A, Forsting M. Unusual Spinal dural arteriovenous fistula: digital subtraction and magnetic resonance angiography. Klin Neuroradiol, 2009,19(2):157-161.
[7]Pattany PM, Saraf-Lavi E, Bowen BC. MR Angiography of the spine and spinal cord.Top Magn Res Imaging, 2003, 14(6): 444-446.
[8]Kim DJ, Willinsky R, Geibprasert S,et al. Angiography characteristics and treatment of cervical spinal dural arteriovenous shunts. AJNR AM J Neuroradiol, 2010,31(8): 1512-1515.
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