Touho H, Karasawa J, Ohnishi H, Ueda S
Department of Neurosurgery, Osaka Neurological Institute.
Neurol Med Chir (Tokyo). 1995 Jul;35(7):445-9. doi: 10.2176/nmc.35.445.
This preliminary study investigated local hemodynamic changes in intramedullary spinal arteriovenous malformation (AVM) before and after embolization. 99mTcO4- was injected into the anterior spinal artery feeding the AVM via a Tracker-10 or MAGIC microcatheter. Time-dependent radioisotope images were sequentially obtained in the anteroposterior plane every 0.2 sec before and just after embolization. Local mean transit time (MTT) was then calculated for both the nidus and draining vein and compared before and after embolization. Prior to embolization, MTTs in the nidus and in the draining vein were 1.84 +/- 0.62 (mean +/- SD) and 2.80 +/- 0.69 sec for the five patients, respectively. MTTs in both the nidus and the draining vein were significantly prolonged after embolization to 3.32 +/- 1.14 and 4.90 +/- 0.93 sec, respectively (p < 0.02 and p < 0.005, respectively). In vivo measurements of local hemodynamic changes in the spinal cord during the treatment of spinal AVMs could be achieved. This method may allow investigation of the hemodynamic mechanisms which induce ischemic symptoms in patients with spinal AVM.
这项初步研究调查了脊髓动静脉畸形（AVM）栓塞前后的局部血流动力学变化。通过Tracker-10或MAGIC微导管将99mTcO4-注入为AVM供血的脊髓前动脉。在栓塞前及栓塞后即刻，每隔0.2秒在前位平面顺序获取随时间变化的放射性同位素图像。然后计算畸形血管团和引流静脉的局部平均通过时间（MTT），并对栓塞前后进行比较。栓塞前，5例患者畸形血管团和引流静脉的MTT分别为1.84±0.62（平均值±标准差）和2.80±0.69秒。栓塞后，畸形血管团和引流静脉的MTT均显著延长，分别为3.32±1.14和4.90±0.93秒（分别为p<0.02和p<0.005）。可以实现脊髓动静脉畸形治疗期间脊髓局部血流动力学变化的体内测量。该方法可能有助于研究脊髓动静脉畸形患者诱发缺血症状的血流动力学机制。
