CT血管成像在头皮巨大动静脉畸形诊断中的应用

摘要

目的 探讨CT血管造影(CTA)在头皮巨大动静脉畸形诊断中的应用价值.方法 选择7例头皮巨大血管畸形患者,分析其影像资料,所有患者均经16层螺旋CT双能量同步扫描CTA技术确诊,平扫后再行CTA容积扫描的动静脉同期显示全脑血管成像.然后使用常规CTA和减影CTA的容积再现(VR)、最大密度投影(MIP)、多平面成像(MRP)后处理技术观察图像.结果 4例头皮巨大动静脉畸形,同时合并头皮-颅骨-脑膜动静脉瘘1例,合并动静脉瘘2例,CT平扫结果显示:头皮团块状软组织影增厚.增强扫描显示:蚯蚓状或条状迂曲强化的血管影,有粗大的供血动脉及引流静脉.两例还在窦汇区见颅骨内增多扭曲血管与窦汇相连,双侧小脑幕窦显示,直窦顶部与上矢状窦间见细小大脑镰状静脉影相连.一例出现左侧横窦微小变异.结论 通过CTA重建,颅骨结构间的空间关系及动静脉畸形的3种组成部分的空间关系能够被充分显示,能够代替常规的DSA检查,在头皮动静脉畸形的筛查、诊断方面具有很高的诊断价值,值得推广.%Objective To investigate the application value of CT angiography (CTA) in the diagnosis of huge dynamic scalp venous malformations.Methods 7 cases of huge scalp vascular malformation patients were selected,the image data were analyzed,all patients were treated by 16 slice spiral CT dual energy CTA synchronous scanning technology confirmed,scan line after the CTA volume scanning arteriovenous period show cerebral angiography.Volume and then using conventional CTA and subtraction CTA reconstruction (VR),maximum intensity projection (MIP),multiple planar reconstruction (MRP) images were observed after treatment technology.Results Huge scalp arteriovenous malformation in 4 cases,at the same time with scalp-Skull meningeal 1 suffered from arteriovenous fistula,complicated with arteriovenous fistula in 2 cases,CT scan showed:the shadow of soft tissue thickening scalp lump.Enhanced scan showed:earthworm or strip tortuosity enhanced vessels,coarse feeding artery and draining vein.Two patients in sinus in the region to see inside the skull and torcular increased twisted blood vessels connected,bilateral tentorial sinus,straight sinus and the top of the superior sagittal sinus between tiny brain sickle vein shadow.A case of left transverse sinus tiny variations.Conclusion By CTA reconstruction,spatial relationship between structure of skull and 3 components of the spatial relationship between venous malformation can be fully displayed,to replace the conventional DSA examination,and has high diagnostic value in scalp venous malformations of the dynamic screening,diagnosis,and is worthy of promotion.