Mironov A
Department of Neuroradiology, Kantonsspital Aarau, Switzerland.
Acta Radiol. 1995 Nov;36(6):582-92.
A classification of dural arteriovenous fistulas (DAVFs) according to their pathogenesis has not been established. The purpose of this study was to examine the hypothesis that the different angiomorphologies of DAVFs depend on the location of the venous recipient, and that a territorial classification of spontaneous DAVFs can be created based on their acquired development.
The clinical and radiographic findings of 96 patients with DAVFs were reviewed, especially with regard to their venous characteristics.
DAVFs were subdivided into 5 groups: Type 1--DAVFs of the dural sinuses (n = 39); Type 2--DAVFs of the cavernous sinus (n = 29); Type 3--DAVFs of Galen's system (n = 10); Type 4--DAVFs of the venous plexus at the base of the skull (n = 9); Type 5--DAVFs of the parasinusal cortical veins (n = 9). The documentation of a causal sinus thrombosis depends on the location of the DAVF: in 72% of the cases with type 1 DAVFs there was a thrombosis at the time of the investigation, but no thrombosis could be proved in cases with type 4 DAVFs.
The morphological development of DAVFs seems to depend on the flow volume of the venous recipient. A pronounced development of pathological AV shunts takes place at the level of the large basal dural sinuses. A delayed development of pathological AV shunts with a low shunt volume occurs in a venous recipient with a low AV pressure gradient.
尚未建立根据发病机制对硬脑膜动静脉瘘（DAVF）进行的分类。本研究的目的是检验以下假设：DAVF的不同血管形态取决于静脉引流部位，并且可以基于其获得性发展建立自发性DAVF的区域分类。
回顾了96例DAVF患者的临床和影像学表现，尤其关注其静脉特征。
DAVF分为5组：1型——硬脑膜窦DAVF（n = 39）；2型——海绵窦DAVF（n = 29）；3型——Galen系统DAVF（n = 10）；4型——颅底静脉丛DAVF（n = 9）；5型——窦旁皮质静脉DAVF（n = 9）。因果性窦血栓形成的记录取决于DAVF的部位：在1型DAVF病例中，72%在检查时有血栓形成，但在4型DAVF病例中未证实有血栓形成。
DAVF的形态学发展似乎取决于静脉引流部位的血流量。在大的基底硬脑膜窦水平会发生明显的病理性动静脉分流。在动静脉压力梯度低的静脉引流部位会出现病理性动静脉分流的延迟发展且分流流量低。
