Krings Timo, Mull Michael, Gilsbach Joachim M, Thron Armin
Department of Neuroradiology, University Hospital Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany.
Eur Radiol. 2005 Feb;15(2):267-78. doi: 10.1007/s00330-004-2510-2. Epub 2004 Oct 22.
Spinal vascular malformations are rare diseases that consist of true inborn cavernomas and arteriovenous malformations (including perimedullary fistulae, glomerular and juvenile AVMs) and presumably acquired dural arteriovenous fistulae. This review article gives an overview of the imaging features both on MRI and angiography, the differential diagnoses, the clinical symptomatology and the potential therapeutic approaches to these diseases. It is concluded that MRI is the diagnostic modality of first choice in suspected spinal vascular malformation and should be complemented by selective spinal angiography. Treatment in symptomatic patients offers an improvement in the prognosis, but should be performed in specialized centers. Patients with spinal cord cavernomas and perimedullary fistulae type I are surgical candidates. Dural arteriovenous fistulae can either be operated upon or can be treated by an endovascular approach, the former being a simple, quick and secure approach to obliterate the fistula, while the latter is technically demanding. In spinal arteriovenous malformations, the endovascular approach is the method of first choice; in selected cases, a combined therapy might be sensible.
脊髓血管畸形是一种罕见疾病，包括真性先天性海绵状血管瘤和动静脉畸形（包括髓周瘘、肾小球样和青少年动静脉畸形）以及可能后天获得的硬脊膜动静脉瘘。这篇综述文章概述了这些疾病在磁共振成像（MRI）和血管造影上的影像学特征、鉴别诊断、临床症状以及潜在的治疗方法。得出的结论是，MRI是疑似脊髓血管畸形的首选诊断方式，应辅以选择性脊髓血管造影。有症状患者的治疗可改善预后，但应在专业中心进行。脊髓海绵状血管瘤和I型髓周瘘患者适合手术治疗。硬脊膜动静脉瘘既可以进行手术，也可以采用血管内治疗方法，前者是一种简单、快速且安全的瘘管闭塞方法，而后者技术要求较高。在脊髓动静脉畸形中，血管内治疗是首选方法；在某些特定情况下，联合治疗可能是合理的。
