脊髓硬脊膜动静脉瘘1例并文献复习

doi:10.3969/j.issn.1004-583X.2024.09.011

摘要/Abstract

摘要：

目的探讨脊髓硬脊膜动静脉瘘(spinal dural arteriovenous fistulas,SDAVF)的临床表现、发病机制和影像学特点。方法回顾1例SDAVF患者的诊治过程,并复习相关文献。结果患者为61岁男性,以行走困难为首发症状,随后出现感觉及尿便障碍,脊柱磁共振成像可见条状T2长信号,脊髓血管造影显示L1节段可见脊髓动静脉瘘。结论 SDAVF较为罕见,且临床表现不典型,脊髓血管造影是确诊的金标准,确诊后应尽快行手术治疗。

关键词: 动静脉瘘, 诊断, 磁共振成像, 血管造影术

Abstract:

Objective To study the clinical manifestations, pathogenesis and imaging pattern of spinal dural arteriovenous fistula (SDAVF). Methods The diagnosis and treatment of a SDAVF patient was analyzed retrospectively, and the related literature was reviewed. Results The 61-year-old male patient presented mobility limitation as initial symptom, followed by urination and defecation dysfunction, with strip long T2 signal in magnetic resonance imaging and spinal arteriovenous fistula at L1 segment in spinal angiography. Conclusion Although SDAVF is very rare and clinically atypical, spinal angiography is the gold standard for confirmed diagnosis, and surgery should be performed as soon as possible after diagnosis.

Key words: arteriovenous fistula, diagnosis, magnetic resonance imaging, angiography

中图分类号:

R654.4

散丹, 甄瑾. 脊髓硬脊膜动静脉瘘1例并文献复习[J]. 临床荟萃, 2024, 39(9): 825-827.

San Dan, Zhen Jin. Spinal dural arteriovenous fistula: A case report and literature review[J]. Clinical Focus, 2024, 39(9): 825-827.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.09.011

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I9/825

图/表 4

参考文献 18

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	头颅	颈椎	胸椎	腰椎	左腕关节	胸部
平扫	MRI+DWI+FLAIR(2023-06-09):①多发腔隙灶;②脑白质病变Fazekas 1级	MRI+STIR(2023-06-05):①C3-4、C4-5、C5-6、C6-7椎间盘突出;②C3-4、C4-5、C5-6、C6-7水平椎管略狭窄	MRI+STIR(2023-06-11):①T7-T12水平脊髓异常信号;②多发胸椎椎体及附件区异常信号;③考虑T11椎体血管瘤	CT(2023-06-10):L2-3、L3-4、L4-5、L5-S1椎间盘膨出	正侧位X线(2023-06-10):左桡骨远端骨折外固定术后改变	X线/CT(2023-06-09):①支气/细支气管炎;②肺气肿;③双肺轻度间质性改变
增强	MRI+DWI+SWI+FLAIR(2023-06-09):①多发腔隙灶;②脑白质病变Fazekas 1级	MRI+STIR(2023-06-10):①C4-5、C5-6、C6-7椎间盘突出;②同节段水平椎管狭窄	MRI+STIR(2023-06-11):①T6-T12水平脊髓异常信号,脊髓炎?②多发胸椎椎体及附件区异常信号;③考虑T11椎体血管瘤

	头颅	颈椎	胸椎	腰椎	左腕关节	胸部
平扫	MRI+DWI+FLAIR(2023-06-09):①多发腔隙灶;②脑白质病变Fazekas 1级	MRI+STIR(2023-06-05):①C3-4、C4-5、C5-6、C6-7椎间盘突出;②C3-4、C4-5、C5-6、C6-7水平椎管略狭窄	MRI+STIR(2023-06-11):①T7-T12水平脊髓异常信号;②多发胸椎椎体及附件区异常信号;③考虑T11椎体血管瘤	CT(2023-06-10):L2-3、L3-4、L4-5、L5-S1椎间盘膨出	正侧位X线(2023-06-10):左桡骨远端骨折外固定术后改变	X线/CT(2023-06-09):①支气/细支气管炎;②肺气肿;③双肺轻度间质性改变
增强	MRI+DWI+SWI+FLAIR(2023-06-09):①多发腔隙灶;②脑白质病变Fazekas 1级	MRI+STIR(2023-06-10):①C4-5、C5-6、C6-7椎间盘突出;②同节段水平椎管狭窄	MRI+STIR(2023-06-11):①T6-T12水平脊髓异常信号,脊髓炎?②多发胸椎椎体及附件区异常信号;③考虑T11椎体血管瘤