Nocuń Anna, Szajner Maciej, Gil Krzysztof, Zaorska-Rajca Janina
Department of Nuclear Medicine, Skubiszewski Medical University of Lublin, Poland.
Nucl Med Rev Cent East Eur. 2004;7(1):43-8.
Arteriovenous malformations (AVM) markedly alter the distribution of the regional cerebral blood flow, as they consist of abnormal arteries and veins with no resistance vessels between them. The aim of this study was to the evaluate diagnostic utility of cerebral perfusion scintigraphy (dynamic phase and SPECT) in patients with AVM.
Nineteen patients were examined. All the patients had been previously diagnosed with AVM and qualified for intravascular embolization. Brain scintigraphy was performed with 99mTc-ECD and included dynamic phase and SPECT imaging. The regional blood flow was evaluated visually and semi quantitatively, based on comparison between the activity in the two symmetrical regions of interest. Differences higher than 10% were considered significant. Cerebral angiography combined with intravascular embolization was carried out after a scitigraphic examination.
Based on angiograms, the diameter of the AVM nidus was estimated and varied from 1.0 cm to 9.0 cm. In 13 cases, AVM were visible in the dynamic scintigraphy as areas of increased tracer activity. In each case, SPECT images showed the AVM nidus as a region of decreased tracer accumulation. Hypoperfusion in the brain tissue adjacent to the nidus was seen in 15 subjects. In one patient cerebellar diaschisis was present. The average ratio of activity in the region of AVM to activity in the normally perfused tissue calculated by semiquantitative analysis was 77.5 +/- 10.9%.
Cerebral perfusion scintigraphy (SPECT images and dynamic scintigraphy) allows one to identify perfusion disturbances caused by the presence of intracranial AVM.
动静脉畸形（AVM）显著改变局部脑血流分布，因为它们由异常动脉和静脉组成，其间没有阻力血管。本研究的目的是评估脑灌注闪烁显像（动态期和单光子发射计算机断层显像[SPECT]）在AVM患者中的诊断效用。
对19例患者进行了检查。所有患者此前均被诊断为AVM且符合血管内栓塞治疗条件。使用99mTc-ECD进行脑闪烁显像，包括动态期和SPECT成像。基于两个对称感兴趣区域内活性的比较，对局部血流进行视觉和半定量评估。差异高于10%被认为具有显著性。在闪烁显像检查后进行脑血管造影并联合血管内栓塞治疗。
根据血管造影片估计AVM病灶直径，范围为1.0 cm至9.0 cm。在13例中，AVM在动态闪烁显像中表现为示踪剂活性增加区域。在每例中，SPECT图像显示AVM病灶为示踪剂聚集减少区域。15例患者在病灶邻近脑组织出现灌注不足。1例患者存在小脑交叉性机能缺失。通过半定量分析计算的AVM区域活性与正常灌注组织活性的平均比值为77.5±10.9%。
脑灌注闪烁显像（SPECT图像和动态闪烁显像）能够识别由颅内AVM存在所导致的灌注紊乱。
