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血管畸形的分类、诊断及介入放射学管理

Classification, diagnosis, and interventional radiologic management of vascular malformations.

作者信息

Legiehn Gerald M, Heran Manraj K S

机构信息

Department of Radiology, Division of Interventional Radiology, Vancouver General Hospital, University of British Columbia, 899 West Twelfth Avenue, Vancouver, British Columbia, Canada, V5Z 1M9.

出版信息

Orthop Clin North Am. 2006 Jul;37(3):435-74, vii-viii. doi: 10.1016/j.ocl.2006.04.005.

Abstract

Vascular anomalies are comprised of either hemangiomas or vascular malformations.Low-flow vascular malformations can be divided into capillary, venous, and lymphatic types and are usually present at birth, undergo pari passu growth, and produce symptoms related to mass effect or stasis. High-flow malformations are comprised pre-dominantly of arteriovenous malformations that follow a more aggressive clinical course of hyperemia, adjacent mass effect, steal phenomenon, tissue destruction, and ultimately high output failure. Ultrasound, CT, nuclear medicine, angiography, and particularly MRI have greatly enhanced diagnostic accuracy and provide detailed information for percutaneous and surgical treatment planning and an objective means of following therapeutic efficacy. Interventional radiologic percutaneous sclerotherapy for low-flow lesions and embolosclerotherapy for high-flow lesions with or without adjunctive surgical intervention have become the mainstay of therapy.

摘要

血管异常由血管瘤或血管畸形组成。低流量血管畸形可分为毛细血管型、静脉型和淋巴管型,通常在出生时即存在,随身体发育同步生长,并产生与占位效应或淤血相关的症状。高流量畸形主要由动静脉畸形组成,其临床过程更为凶险,包括充血、相邻占位效应、盗血现象、组织破坏,最终导致高输出量衰竭。超声、CT、核医学、血管造影,尤其是MRI,极大地提高了诊断准确性,并为经皮治疗和手术治疗规划提供详细信息,以及跟踪治疗效果的客观手段。对于低流量病变,介入放射学经皮硬化治疗以及对于高流量病变的栓塞硬化治疗,无论有无辅助手术干预,都已成为主要的治疗方法。

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