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目的探讨MRI对椎管内动静脉畸形(AVM)的诊断价值。方法分析13例经手术或DSA证实的椎管内AVM的MRI表现及其临床资料,其中髓内AVM4例,硬膜内AVM6例,硬膜外AVM3例。结果 13例椎管内AVM有12例MRI清楚显示畸形血管。4例髓内AVM中3例畸形血管呈团状,1例未见明显血管影,均合并出血;6例硬膜内AVM中5例畸形血管呈迂曲蚯蚓状,其中1例蚯蚓状、团状兼有,3例脊髓出现水肿或缺血性改变,并伴病变部位以上脊髓内空洞形成,2例病变脊髓萎缩,1例病变处脊髓呈水肿改变;3例硬膜外AVM畸形血管呈匍行蚯蚓状,病变水平脊髓受压,其中1例病变处脊髓萎缩,2例合并硬膜外血肿。结论椎管内不同类型的AVM影像表现及其继发改变不尽相同,MRI能准确反映不同类型AVM的影像特点及其继发改变,是椎管内AVM的首选检查方法。
Objective To investigate the diagnostic value of MRI for AVM in spinal canal. Methods MRI findings and clinical data of 13 cases of vertebral AVM confirmed by surgery or DSA were analyzed. There were 4 cases of intramedullary AVM, 6 cases of intradural AVM and 3 cases of epidural AVM. Results Thirteen cases of AVM in spinal canal showed clear deformity vessels in 12 cases. In 4 cases of AVM, 3 cases of intracranial AVM were in clumpy group, 1 case had no obvious blood vessels and all had hemorrhage. Among the 6 cases, 5 cases of intradural AVM showed tortuous earthworm, of which 1 case was earthworm, In both cases, edema or ischemic changes were found in 3 cases of spinal cord, accompanied by cavities in the spinal cord above the lesion, 2 cases of spinal cord atrophy and 1 case of spinal cord edema. 3 cases of epidural AVM malformations showed creeping Earthworm-shaped, the level of spinal cord compression, including 1 case of spinal cord atrophy lesions, 2 cases combined with epidural hematoma. Conclusions Different types of AVM images in spinal canal and their secondary changes are different. MRI can accurately reflect the imaging features and secondary changes of different types of AVM. It is the first choice of AVM in spinal canal.