Tortuous, engorged pial veins in intracranial dural arteriovenous fistulas: correlations with presentation, location, and MR findings in 122 patients.
Tortuous, engorged pial veins in intracranial dural arteriovenous fistulas: correlations with presentation, location, and MR findings in 122 patients.
复制标题
颅内硬脑膜动静脉瘘中弯曲、充血的软脑膜静脉：与 122 名患者的表现、位置和 MR 结果的相关性。
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
W. Montanera
中科院分区：
文献类型：
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作者：
R. Willinsky;M. Goyal;K. terBrugge;W. Montanera
背景和目的
对于与颅内硬脑膜动静脉瘘 (DAVF) 相关的静脉充血患者，可以在脑循环的静脉相上识别出弯曲、充血的静脉。术语假静脉模式（PPP）已被用来描述这一发现。本研究的目的是确定颅内 DAVF 患者 PPP 的患病率，并分析该体征与表现、瘘管位置、逆行软脑膜静脉引流的存在以及 MR 结果的关系。
方法
我们回顾性分析了 130 例颅内 DAVF 患者的病历和影像学结果。对 122 名患者的脑循环静脉期进行了充分评估。 PPP 分为轻度、中度或重度。
结果
51 名患者 (42%) 发现了 PPP。 44 名出现出血、神经功能缺损或癫痫发作的患者中，有 32 名 (73%) 患有 PPP，而 75 名出现杂音或眼眶体征的患者中，有 16 名 (21%) 患有 PPP。三名患有充血性心力衰竭或头围增大的患者患有 PPP。 16 名患有上矢状窦、直窦或岩上窦瘘的人中，有 14 名 (88%) 患有 PPP。 57 名接受逆行软脑膜静脉引流的患者中有 46 名 (81%) 出现 PPP，而 65 名仅接受鼻窦引流的患者中有 5 名 (8%) 出现 PPP。 MR 图像上显示白质 T2 高信号的 16 名患者中，有 14 名 (88%) 患有严重的 PPP。
结论
PPP 反映静脉充血，并与伴有或不伴有逆行软脑膜静脉引流的侵袭性表现相关。 PPP 可能是一个有用的预后指标，应在治疗决策中予以考虑。
BACKGROUND AND PURPOSE
Tortuous, engorged veins can be identified on the venous phase of the brain circulation in patients with venous congestion related to an intracranial dural arteriovenous fistula (DAVF). The term pseudophlebitic pattern (PPP) has been used to describe this finding. The purpose of this study was to determine the prevalence of PPP in patients with intracranial DAVF and to analyze the relationship of this sign to presentation, location of the fistula, presence of retrograde leptomeningeal venous drainage, and MR findings.
METHODS
We retrospectively reviewed the charts and imaging findings of 130 patients with intracranial DAVF. In 122 patients the venous phase of the brain circulation was adequately assessed. The PPP was graded as mild, moderate, or severe.
RESULTS
PPP was found in 51 patients (42%). Thirty-two (73%) of the 44 patients who had a hemorrhage, neurologic deficit, or seizure had PPP as compared with 16 (21%) of the 75 who had a bruit or orbital signs. The three patients with either congestive heart failure or increasing head circumference had PPP. Fourteen (88%) of the 16 who had fistula of the superior sagittal sinus, straight sinus, or superior petrosal sinus had PPP. PPP was seen in 46 (81%) of 57 patients who had retrograde leptomeningeal venous drainage and in five (8%) of the 65 who had only sinosal drainage. Fourteen (88%) of the 16 who had white matter T2 hyperintensity on MR images had severe PPP.
CONCLUSION
The PPP reflects venous congestion and is associated with an aggressive presentation with or without retrograde leptomeningeal venous drainage. PPP may be a useful prognostic indicator and should be considered in treatment decisions.