Objective: To explore the clinical value of CT spinal angiography with 256-detector row spiral CT in diagnosing spinal arteriovenous fistula. Materials and Methods: Thirteen patients with initial MR and clinical manifestations suggestive of spinal vascular diseases underwent CT spinal angiography. Among them, 11 patients took DSA examination within 3 to 5 days after CT scan, and 8 patients underwent surgical treatment. Results: Seven cases of 13 patients were diagnosed as dural arteriovenous fistula(SDAVF) and 6 cases were spinal cord perimedullary arteriovenous fistula(SPMAVF), which were consistent with the diagnosis of DSA or surgery. All the 13 patients showed the abnormality of spinal cord vessels and the range of lesions clearly by CT spinal angiography. In the 7 cases of SDAVF, CTA displayed 5 feeding vessels and level of fistula opening in 6 cases, which were consistent with the DSA or surgery. One case was negative in DSA; In 6 cases with .SP-MAVF, CTA displayed 3 feeding vessels and level of fistula opening in 5 cases, which were consistent with the DSA or surgery. Conclusion: CT spinal angiography with 256-detector row spiral CT can show the extent of arteriovenous fistula, feeding artery and the level of fistula clearly. It is safe, non-invasive, rapid compared with DSA, and can be a necessary means for screening exam before DSA, serve as a DSA examination before surgery and postoperative follow-up, or even partially replace DSA.%目的:探讨256层螺旋CT全脊髓血管造影(CTA)在诊断脊髓动静脉瘘中的临床应用价值.方法:13例临床表现及MRI符合脊髓血管病变的患者进行CTA检查,其中11例3～5 d内做DSA检查,8例手术治疗.结果:13例患者7例诊断为硬脊膜动静脉瘘(SDAVF),6例髓周动静脉瘘(SPMAVF),与DSA或手术诊断一致；CTA全部较好的显示了异常血管病变的范围；7例SDAVF中有5例CTA与DSA或手术对供血动脉的诊断一致,6例对瘘口的诊断一致,1例DSA阴性；6例SPMAVF中3例CTA与DSA或手术对供血动脉的诊断一致,5例对瘘口的诊断一致.结论:256层螺旋全脊髓CTA可以清晰的显示脊髓动静脉瘘的病变范围、供血动脉及瘘口的位置,较DSA相比安全、无创、快速,可以作为DSA检查前、指导手术及术后随访必要的检查手段,部分可取代DSA检查.
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