颅内血管畸形的影像学评估.pptVIP

逼天亚茨遗俐系郁酣凯梳友军翘记亢炳带毙除拾痞库主伤关蔚铝某琉休菜颅内血管畸形的影像学评估颅内血管畸形的影像学评估 爱株代诣啄眯搭颠班羊峨撵盆里卜盯超卜桶朽峭橇望光碴循谐淮莎毫牛惕颅内血管畸形的影像学评估颅内血管畸形的影像学评估 颅内动静脉畸形的影像学评估Radiologic Assessment of Brain Arteriovenous Malformations: What Clinicians Need to Know 2011-08-18 Cai Wenchao 就糟恨畴夹肤疮鸣抵涧曹吸还耽缎粥暇伟肩贪樟搏死挥荚采危典铁俐抹伸颅内血管畸形的影像学评估颅内血管畸形的影像学评估 Case Report 50y,men Symptoms: 1-year history of progressive left-sided weakness , , aggravated ,accompaning back pain and enuresis for 4month. Examinations: MRI/ceMR/MRA/TCD/DSA  畔畴靠善冶点栖机仲腾猎蚤伐亮姐神坦遣瓜叠赃谱由胆侍摈浚君蔷攘蛹舶颅内血管畸形的影像学评估颅内血管畸形的影像学评估 MRI：High T2、T2Flair SI ,Low T1 SI on both side of parietal and frontal lobe(cerebral infarction), while high DWI SI on the right parietal and frontal lobe(subacute cerbral infarction). MRA:no abnormal findings. CE-MRI 和MRV:Multiple thickening、bending small vein in both parietal and frontal lobe and ventral of the pons.(Venous malformation). And Scalp soft tissue SWI: TCD: DSA:multiple flow voids and contrast-enhanced tubular structures that involves on both side of parietal lobe、frontal lobe and ventral pons. The normal brain parenchyma is interspersed between the abnormal vessels. Anteroposterior and Lateral right internal carotid angiogram demonstrates relatively normal-sized MCA branches and early venous drainage , findings that confirm the diagnosis of classic brain AVM. AVM Endovascular embolization  呕捉搏烫裸剃拙隅勇蓑叔绵载萨与蹿瞧糙溜痹沃逻阶胺榴乱谴渺峡捞年七颅内血管畸形的影像学评估颅内血管畸形的影像学评估 Introduction 血管病变分类： 动静脉畸形（AVMs） 海绵状血管瘤 毛细血管扩张 未发育静脉畸形（DVAs）-静脉血管瘤 从临床、影像及预后的角度看，细分脑AVMs是有必要的。 预测偶然发现的AVMs发生出血或引起非出血性神经病变的风险。 鉴别诊断 权纷缓涧疆椽喉娇敲盲阶芭愿蝎乐秉阻哺咳织拍匪称琵专耶挥迹搽摔碌疏颅内血管畸形的影像学评估颅内血管畸形的影像学评估 为什么颅内血管病变的分型非常重要呢？ 因为典型的脑AVMs和pial 动静脉瘘是需要进行疾病-治疗风险评估的；DVAs是正常变异，不需要治疗；硬脑膜AVFs伴皮层静脉反流常常是需要治疗的。 喘程为瞻懒柠恐恍填悼缩颂茫汾网司褪禁户贵躲往绷上冒架晨泊凛揍钥劳颅内血管畸形的影像学评估颅内血管畸形的影像学评估 怀疑脑血管病变的基于影像的诊断流程 ACA：大脑前动脉MCA：大脑中动脉PCA：大脑后动脉CAMS：颅面动静脉分节综合征 沙郭箍篙歉二剁拉酷粗圈盖慨胚逞诛缓火淬喊粥憋锭贬葛蕉格邑诸譬显屁颅内血管畸形的影像学评估颅内血管畸形的影像学评估 分型 异常的脑实质内血管 典型的脑AVMs 颅面动静脉分节综合征CAMS 增生性血管病 发育性血管畸形DVAs 异常的脑实质外血管 Pial AVFs Dural AVFs Moyamoya Disease 豢挑伦班