From the Division of Neuroradiology (M.P.K.), Department of Radiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia
Division of Neuroradiology (K.B.), Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
AJNR Am J Neuroradiol. 2021 Dec;42(12):2110-2118. doi: 10.3174/ajnr.A7312. Epub 2021 Oct 14.
Spinal vascular shunts, including fistulas and malformations, are rare and complex vascular lesions for which multiple classification schemes have been proposed. The most widely adopted scheme consists of 4 types: type I, dural AVFs; type II, intramedullary glomus AVMs; type III, juvenile/metameric AVMs; and type IV, intradural perimedullary AVFs. MR imaging and angiography techniques permit detailed assessment of spinal arteriovenous shunts, though DSA is the criterion standard for delineating vascular anatomy and treatment planning. Diagnosis is almost exclusively based on imaging, and features often mimic more common pathologies. The radiologist's recognition of spinal vascular shunts may improve outcomes because patients may benefit from early intervention.
脊髓血管分流包括瘘和畸形，是罕见且复杂的血管病变，为此已经提出了多种分类方案。应用最广泛的方案包括 4 种类型：Ⅰ型，硬脊膜动静脉瘘；Ⅱ型，脊髓内球海绵状血管畸形；Ⅲ型，青少年/节段性动静脉畸形；和Ⅳ型，硬脊膜内脊髓旁动静脉瘘。磁共振成像和血管造影技术可以对脊髓动静脉分流进行详细评估，尽管 DSA 是描绘血管解剖结构和治疗计划的标准。诊断几乎完全基于影像学，其特征常与更常见的病变相类似。放射科医生对脊髓血管分流的认识可能会改善预后，因为患者可能受益于早期干预。
