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[中枢神经系统疾病患儿经神经放射学指征后进行脑血管造影的结果]

[Results of cerebral angiography performed after neuroradiological indications in children with CNS diseases].

作者信息

Gergont Aleksandra, Król-Jawień Wanda, Weryński Piotr, Herman-Sucharska Izabela, Zajac Anna, Gleń Agnieszka

机构信息

Klinika Neurologii Dzieciecej, Uniwersytet Jagielloński Collegium Medicum, Kraków.

出版信息

Przegl Lek. 2007;64(11):937-41.

Abstract

INTRODUCTION

Despite of the constant progress in the imaging of vessels, cerebral angiography characterises with the best specificity and sensitivity in detection of arterial, arteriovenous malformations and aneurysms.

THE AIM

The aim of this study was to compare the results of cerebral angiography and other neuro-radiologic methods in cases suggesting the probability of vascular malformations in children with neurologic syndroms. MATHERIAL AND MEHTODS: In the year 2006 cerebral angiography was performed in 20 children since it was advised after radiological examinations in children hospitalized in the Department of Pediatric Neurology UJ CM in Krakó w. The group of children aged 3-17 years (mean 11 years) consisted of 11 girls and 9 boys. The commonest clinical diagnoses were epilepsy, less common cranial neuropathies, migraine, hemiparesis and agiomatosis of skin. Before cerebral angiography was indicated, other radiological examinations were performed, within CT in 7 cases, CTA in one, MRI in 17 children and MRA in 5. In some children other examinations were also performed, within transcranial doppler evaluation of cerebral blood flow, EEG, video EEG, lumbar puncture and ultrasound eye evaluation.

RESULTS

The pathological changes were detected in 5 CT examinations, 1 CTA, 7 MRI and in 4 MRA, suggesting cerebral vascular malformations. Cerebral angiography excluded vascular malformations in 15 children. In 5 children angiography confirmed however the presence of vascular pathology. In 2 of them arterial hypoplasia in the posterior circulation was detected, in 2 cases supratentorial artery hypoplasia and a single venous cerebellar malformation. Children were diagnosed with migraine with aura in two cases, within one with paresis of the right leg and single cases with skin angiomatosis, syncope and sleep myoclonus.

CONCLUSIONS

Cerebral angiography allowed to exclude vascular pathology in 75% of children, in whom previous neuroradiological examinations suggested such pathology. It was important for their quality of life. In 25% of patients angiography confirmed results of previous neuroradiological tests detecting vascular pathology. MR with contrast medium is more sensitive than angiography in detection of venous angiomas.

摘要

引言

尽管血管成像技术不断进步,但脑血管造影在检测动脉、动静脉畸形和动脉瘤方面具有最佳的特异性和敏感性。

目的

本研究的目的是比较脑血管造影和其他神经放射学方法在提示患有神经综合征的儿童存在血管畸形可能性的病例中的结果。材料与方法:2006年,克拉科夫雅盖隆大学医学院儿科神经科住院儿童经放射学检查后建议进行脑血管造影,共有20名儿童接受了检查。该组儿童年龄在3至17岁之间(平均11岁),其中11名女孩,9名男孩。最常见的临床诊断为癫痫,较少见的有颅神经病变、偏头痛、偏瘫和皮肤血管瘤病。在进行脑血管造影之前,还进行了其他放射学检查,7例进行了CT检查,1例进行了CTA检查,17例进行了MRI检查,5例进行了MRA检查。部分儿童还进行了其他检查,包括经颅多普勒脑血流评估、脑电图、视频脑电图、腰椎穿刺和眼部超声检查。

结果

5例CT检查、1例CTA检查、7例MRI检查和4例MRA检查发现了提示脑血管畸形的病理改变。脑血管造影排除了15名儿童的血管畸形。然而,5名儿童的血管造影证实存在血管病变。其中2例检测到后循环动脉发育不全,2例为幕上动脉发育不全,1例为小脑静脉畸形。2例儿童被诊断为伴有先兆的偏头痛,1例为右腿麻痹,单例为皮肤血管瘤病、晕厥和睡眠肌阵挛。

结论

脑血管造影能够排除75%之前神经放射学检查提示存在血管病变的儿童的血管病变,这对他们的生活质量很重要。25%的患者血管造影证实了之前检测到血管病变的神经放射学检查结果。增强磁共振成像在检测静脉血管瘤方面比血管造影更敏感。

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