Etiological evaluation of dural arteriovenous malformations of the transverse-sigmoid sinuses based on histopathological examination.

基于组织病理学检查的横乙状窦硬脑膜动静脉畸形的病因学评估。

基本信息

批准号：
07457309
负责人：
KUWAYAMA Naoya
金额：
$ 1.47万
依托单位：
TOYAMA MEDICAL AND PHARMACEUTICAL UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

项目摘要

In order to elucidate the pathogenesis of dural arteriovenous malformations (AVM's) of the transverse-sigmoid sinuses, histopathological profiles of this disease were studied in serial sections of completely resected lesions from three patients. The intima of the sinuses was thickened ; interruption and thickening were noted in the elastic laminae. The dural arteries ware markedly twisted and elongated, and showed remarkable fibrous thickening in the intima and adventitia. Veins were markedly dilated and had communication with one another and with the lumens of the venous sinuse. Fistulas were seen not between dural arteries and venous sinuses., but between aetreries with a diameter of about 200 micron and dilated dural veins.The anatomical structure of these fistulas between dural arteries and dural veins was clearly demonstrated in a 3-D reconstruction image by a computer. The essential lesion of this disease was confirmed to be a dural arteriovenous fistula within the wall of of the venous sinuses. We believe that this result could explain the mechanisms of recurrence after transvenous embolization of the involved sinuses, i.e., transvenous embolization occludes the site of draining routes, not the fistulas themselves. These fistulas will be obliterated in most of the lesions, but may find other draining routes through the well-developed venous netwook system around the involved sinuses.

为了阐明横向窦窦的硬脑膜动脉畸形（AVM）的发病机理，研究了该疾病的组织病理学特征，以三名患者的完全切除病变的序列形式进行了研究。鼻窦的内膜变稠。在弹性层中注意到中断和增厚。硬脑膜动脉明显扭曲和伸长，并在内膜和外膜显示出显着的纤维增厚。静脉明显扩张，并彼此交流，并与静脉罪的流明。在硬脑膜动脉和静脉鼻窦之间没有看到瘘管，而是直径约为200微米和扩张的硬脑膜静脉的Aetreries之间。硬脑膜动脉和硬脑膜静脉之间的这些瘘管的解剖结构在3-D重建图像中通过计算机清楚地证明了。该疾病的基本病变被证实是静脉窦壁内的硬脑膜动静脉瘘。我们认为，这一结果可以解释相关鼻窦的透性栓塞后复发的机理，即递质的栓塞阻塞了排水路线的部位，而不是瘘管本身。这些瘘管在大多数病变中都会被抹掉，但可能会通过围绕所涉及的鼻窦周围发达的静脉网络系统找到其他排水路线。