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目的探讨脑内动静脉畸形CT、MRI、CTA、MRA、DSA等影像学表现并进行比较分析。方法收集脑动静脉畸形75例,以手术病理及DSA作为诊断的金标准,比较CT、MRI、CTA、MRA、DSA影像学表现,分析各种影像手段的优缺点。结果CT诊断脑动静脉畸形的敏感性89.3%,MR诊断动静脉畸形的敏感性96%。CT呈团块状、蜂窝状、结节状或条索状;MR呈蚯蚓状或线样无信号流空血管影;CT发现钙化及超早期出血较MR敏感,MR对血肿的分期敏感。CTA、MRA、DSA可见瘤巢、引入动脉影及引流静脉影,CTA、MRA分辨率不及DSA,DSA对动静脉畸形内部结构的显示不及CTA、MRA。影像学表现可以反映脑动静脉畸形的大体病理结构。结论不同的影像手段对动静脉畸形的诊断各具价值,结合不同的影像方法完全可以达到诊断定性的目的
Objective To investigate the imaging findings of CT, MRI, CTA, MRA and DSA in cerebral arteriovenous malformations and compare them. Methods 75 cases of cerebral arteriovenous malformations were collected. The pathological features and DSA were taken as the gold standard for diagnosis. The imaging features of CT, MRI, CTA, MRA and DSA were compared to analyze the advantages and disadvantages of various imaging modalities. Results The sensitivity of CT diagnosis of cerebral arteriovenous malformations was 89.3%. The sensitivity of MR in diagnosing arteriovenous malformations was 96%. CT showed massive, honeycombed, nodular or cord-like; MR was worm-like or line-like signal flow empty blood vessels; CT calcification and early bleeding was more sensitive than MR, MR staging of hematoma sensitive. CTA, MRA, DSA visible tumor nests, the introduction of arterial shadow and drainage venography, CTA, MRA resolution is less than DSA, DSA on the internal structure of the AVM display less than CTA, MRA. Imaging findings can reflect the general pathological structure of cerebral arteriovenous malformations. Conclusion Different imaging modalities have their own value in the diagnosis of arteriovenous malformations, and combined with different imaging methods can achieve the purpose of diagnosis qualitatively