Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
J Clin Neurosci. 2002 May;9 Suppl 1:6-10.
Although conventional neuro-imaging of cerebral arteriovenous malformation (AVM) supports preoperative evaluation, it is still difficult to visualise the detailed anatomical conformation of the AVM, the point of nidus, the feeding arteries or draining veins, and the three-dimensional configuration of nidus in the sulcus or gyrus. In the present study, we investigated the efficacy of enhanced three-dimensional surface MR angiography (surface MRA) and T2 reversed imaging (T2R imaging) in diagnosis and surgical planning for cerebral AVMs. Surface MRA clearly demonstrated nidus adjacent to eloquent area and three-dimensional figures of feeding arteries and draining veins. T2R imaging was useful to differentiate sulcal AVM from gyral AVM, and to estimate the depth of the nidus in the parenchyma. Although it has generally been assumed that nidus is present in the gyrus, T2R imaging clearly demonstrates that most of the nidus is in the sulcus and is possible to be dissected and removed without damaging parenchyma. Indeed, these imaging methods supply clinically relevant data that is difficult to obtain with conventional neuro-imaging and provide better details of lesions, informing surgical planning and decision-making.
尽管传统的神经影像学可以支持脑动静脉畸形（AVM）的术前评估，但仍然难以可视化 AVM 的详细解剖形态、病灶点、供血动脉或引流静脉，以及沟回内病灶的三维形态。本研究旨在探讨增强三维表面磁共振血管造影（surface MRA）和 T2 反转成像（T2R 成像）在脑 AVM 诊断和手术计划中的作用。Surface MRA 清晰地显示了临近功能区的病灶、供血动脉和引流静脉的三维图像。T2R 成像有助于区分脑沟 AVM 和脑回 AVM，并估计病灶在脑实质中的深度。尽管普遍认为病灶位于脑回，但 T2R 成像清楚地表明，大部分病灶位于脑沟内，可以在不损伤脑实质的情况下进行分离和切除。事实上，这些成像方法提供了临床相关的数据，这些数据是传统神经影像学难以获得的，并且可以更详细地了解病变情况，为手术计划和决策提供信息。
