DURAL ARTERIOVENOUS-FISTULAS - EVALUATION WITH MR IMAGING
DURAL ARTERIOVENOUS-FISTULAS - EVALUATION WITH MR IMAGING
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DOI：
10.1148/radiology.175.1.2315480
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发表时间：
1990-04-01
期刊：
影响因子：
19.7
通讯作者：
TSURUDA, JS
中科院分区：
文献类型：
--
作者：
DEMARCO, JK;DILLON, WP;TSURUDA, JS
脑硬脑膜动静脉瘘(DAVF)的血管造影前诊断可能很困难。对12例经血管造影证实的DAVF患者的磁共振(MR)图像进行评估，以确定这些病变的特征，并确定哪些患者有更高的并发症风险。表现为静脉闭塞疾病的DAVF患者发生动脉化侧支静脉系统并发症的风险更高。这种静脉闭塞性疾病在动脉造影术中表现最佳。无实质结节的皮质静脉扩张的MR影像表现提示DAVF有静脉闭塞性疾病。我们系列中的12名患者中有8名在血管造影术中证实了这一发现。在8名有静脉闭塞疾病磁共振成像证据的患者中，在磁共振成像中发现了包括梗塞和出血在内的并发症。在血管造影术中，42%的并发症不明显。在1例DAVF引流至畅通的右乙状窦的患者中，MR检查结果正常。虽然没有静脉闭塞疾病的DAVF患者在MRI上可能有正常的表现，但与静脉闭塞疾病和软脑膜静脉扩张引流相关的DAVF在MR图像上可以被记录下来。这一亚组DAVF患者，其中许多人只有在磁共振成像中才被发现，由于静脉闭塞疾病导致并发症的风险更高。据信，这些患者需要更紧急的治疗。磁共振成像有助于DAVF患者的治疗前计划。
The preangiographic diagnosis of cerebral dural arteriovenous fistula (DAVF) can be difficult. The magnetic resonance (MR) images of 12 patients with angiographically proved DAVF were evaluated to characterize the appearance of these lesions and to identify those patients at increased risk for complications. Patients with DAVF demonstrating venous occlusive disease are at higher risk for complications from the arterialized collateral venous system. This venous occlusive disease is demonstrated best at arteriography. The MR imaging appearance of dilated cortical veins without a parenchymal nidus is suggestive of a DAVF with veno-occlusive disease. Eight of the 12 patients in our series demonstrated this finding at angiography. Complications, including infarction and hemorrhage, were identified at MR imaging in eight patients with MR imaging evidence of veno-occlusive disease. At angiography 42% of these complications were not apparent. In one patient with a DAVF draining into an unobstructed right sigmoid sinus, results of MR study were normal. Although patients with DAVF without veno-occlusive disease may have normal findings at MR imaging, DAVF associated with veno-occlusive disease and dilated pial venous drainage can be documented on MR images. This subset of DAVF patients, many of whom were identified only at MR imaging, is at higher risk for complications due to veno-occlusive disease. These patients are believed to require more urgent therapy. MR imaging is useful in the pretherapeutic planning for patients with DAVF.