三维CT血管造影结合DSA手术治疗硬脑膜动静脉瘘

山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (9): 77-80.

三维CT血管造影结合DSA手术治疗硬脑膜动静脉瘘

王益华，郝晓光，王成伟，曲春城，李卫国，王志刚

山东大学第二医院神经外科，济南 250033

收稿日期:2010-07-17 出版日期:2011-09-10 发布日期:2011-09-10
通讯作者: 王志刚，男，主任医师，博士生导师，主要从事脑血管病手术及介入治疗的研究。 E-mail:wzg1110@126.com
作者简介:王益华(1977- )，男，博士，主治医师，主要从事脑血管病手术及介入治疗的研究。

Successful resection of DAVF facilitated by CTA and DSA imaging

WANG Yi-hua， HAO Xiao-guang， WANG Cheng-wei， QU Chun-cheng， LI Wei-guo， WANG Zhi-gang

Department of Neurosurgery, The Second Hospital of Shandong University, Jinan 250033, China

Received:2010-07-17 Online:2011-09-10 Published:2011-09-10

摘要/Abstract

摘要：

目的总结颅脑三维CT血管造影(CTA)结合全脑数字减影血管造影(DSA)手术治疗硬脑膜动静脉瘘(DAVF)的经验。方法描述16例硬脑膜动静脉瘘病例的诊疗过程。全部患者均行全脑血管造影并应用64排螺旋CT行CTA，用DSA分析硬脑膜动静脉瘘的血液动力学，用CTA分析瘘口的解剖学特性。16例均行手术切除，其中有6例患者为介入栓塞不成功后改手术治疗，1例患者为介入栓塞后复发行手术切除。手术入路根据瘘口位置不同而选用经额、经翼点或经枕下经小脑幕入路等。结果所有患者均成功地进行了手术治疗。术后两周DSA复查显示，瘘口未再显影，DAVF消失，治疗效果满意。半年后仍无复发。结论硬脑膜动静脉瘘可在CTA结合DSA下成功地进行手术切除。

关键词: 硬脑膜动静脉瘘;全脑血管造影;CT血管造影

Abstract:

Objective To summarize the successful treatment of cerebral dural arteriovenous fistula (DAVF) with the imaging help of brain three-dimensional CT angiography (CTA) and cerebral digital subtraction angiography (DSA). Methods 16 cases of DAVF were documented. Each patient was subjected to imaging diagnosis by DSA and CTA. DSA revealed the hemodynamic properties and CTA showed the anatomical features of the fistulas. Surgery was performed on all 16 patients, including 6 from unsuccessfully embolization and 1 recurrence after embolization treatment. Surgical procedures were designed according to fistular location, and transfrontal, transperitoneal or suboccipital approach was undertaken. Results The procedures were successful on all patients, as confirmed by follow-up DSA 2 weeks post-surgery: the DAVFs were had disappeared. No recurrence was detected 6 months post-surgery. Conclusion Dural arteriovenous fistula can be successfully resected with the help of CTA and DSA imaging.

Key words: Dural arteriovenous fistula; Digital subtraction angiography; CT angiography

中图分类号:

R651

王益华，郝晓光，王成伟，曲春城，李卫国，王志刚. 三维CT血管造影结合DSA手术治疗硬脑膜动静脉瘘[J]. 山东大学学报(医学版), 2011, 49(9): 77-80.

WANG Yi-hua， HAO Xiao-guang， WANG Cheng-wei， QU Chun-cheng， LI Wei-guo， WANG Zhi-gang. Successful resection of DAVF facilitated by CTA and DSA imaging[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(9): 77-80.

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