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[颌骨中心动静脉畸形的血管造影分类及治疗的初步研究]

[A preliminary study of angiographic classification and treatment of central arteriovenous malformations in jaws].

作者信息

Liu Deng-gao, Ma Xu-chen, Zhao Fu-yun, Zhang Jian-guo

机构信息

Department of Radiology, Peking University School of Stomatology, Beijing 100081, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2005 May;40(3):195-9.

Abstract

OBJECTIVE

To elaborate on the angiographic classification of central arteriovenous malformations (AVMs) in jaws, and to evaluate the correlation between this classification and treatment options.

METHODS

X-ray films and angiograms of 25 cases with AVMs in the jaw were retrospectively reviewed to evaluate the appearance of radiolucency, feeding arteries, nidus of the malformations and draining veins. Based on the findings a classification of angioarchitecture was recommended. Furthermore, the treatment results of these cases were reviewed to assess the correlation between this classification and treatment options.

RESULTS

The angiographic pictures of 25 cases with central AVMs could be divided into five types: type I (n = 5) was with merely diffused micro-arteriovenous fistulas (AVFs); type II (n = 8) demonstrated a large venous pouch, all the feeding arteries drained into it; type III (n = 7) had a large venous pouch together with diffused micro-AVFs (I + II); type IV (n = 2) had multiple venous pouches; type V (n = 3) had multiple venous pouches and diffused micro-AVFs (I + IV). The angioarchitecture corresponded well to the radiographic appearance in all except one case. With respect to the treatment, type II, III, IV AVMs gained clinical cure in 100% of cases, whereas type I and type V AVMs obtained clinical cure only in 3 of 5 and 1 of 3 cases respectively.

CONCLUSIONS

Central AVMs in jaws exhibited variant patterns of angioarchitecture, which could be divided into five types. Elaboration of this classification was helpful for decision-making on choosing appropriate therapy.

摘要

目的

阐述颌骨中心动静脉畸形(AVM)的血管造影分类,并评估该分类与治疗方案之间的相关性。

方法

回顾性分析25例颌骨AVM患者的X线片和血管造影,以评估透射区、供血动脉、畸形瘤巢和引流静脉的表现。基于这些发现,推荐一种血管构筑分类法。此外,回顾这些病例的治疗结果,以评估该分类与治疗方案之间的相关性。

结果

25例中心性AVM的血管造影图像可分为五种类型:I型(n = 5)仅有弥漫性微动静脉瘘(AVF);II型(n = 8)显示一个大的静脉囊袋,所有供血动脉均汇入其中;III型(n = 7)有一个大的静脉囊袋和弥漫性微AVF(I + II);IV型(n = 2)有多个静脉囊袋;V型(n = 3)有多个静脉囊袋和弥漫性微AVF(I + IV)。除1例病例外,血管构筑与放射学表现吻合良好。在治疗方面,II型、III型、IV型AVM的所有病例均获得临床治愈,而I型和V型AVM分别仅在5例中的3例和3例中的1例获得临床治愈。

结论

颌骨中心性AVM表现出多种血管构筑模式,可分为五种类型。阐述该分类有助于选择合适治疗方法的决策。

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