摘要
Abstract
Objective To evaluate the imaging and clinical features of myelopathy caused by dural arteriovenous fistula (DAVF) in craniocervical junction. Methods The clinical and imaging data (including DSA, CTA and MRI) of 16 patients with DAVF in craniocervical junction from Chengdu Fifth People’s Hospital from August 2005 to July 2016 were retrospectively analyzed. All patients were diagnosed by digital subtraction angiography (DSA). 4 cases underwent CTA and 12 cases underwent MRI. According to the time of onset, 16 patients were divided into acute (within 7 days of onset), subacute (within 1 month of onset) and chronic (beyond 1 month of onset) groups. Results 4 cases in acute group, 4 cases in subacute group and 8 cases in chronic group. The proportions of male in acute and chronic patients were both 75.0%, which was higher than that in subacute patients (50.0%). In terms of the direction of venous drainage, 87.5% of chronic patients (7 cases) had ascending venous draining, while 75.0% of acute and 50.0% of subacute patients had similar direction pattern. Nonspecific symptoms, such as headache, dizziness, nausea and vomiting were observed in all patients. DSA images showed that DAVF was primarily located in C1 nerve root, right dural arteriovenous fistula, bilateral sigmoid sinus, transverse sinus, right posterior meningeal artery near transverse sinus, right dural arteriovenous fistula orifice, left/right vertebral artery area, occipital foramen area, right middle meningeal artery branch, sinus confluence area, tentorium area and bilateral cavernous sinus. 4/5 patients who underwent CTA examination showed positive, and the CTA displayed subarachnoid hemorrhage, as well as the number, shape and thickness of the vessels. 12 patients received MRI scan, abnormal vessel flow void signal and abnormal signal in brain parenchymal area were displayed on MRI. Conclusions The clinical characteristics of DAVF in craniocervical junction is related to the direction of venous drainage, not the location of arteriovenous fistula; CTA and MRI are helpful to diagnose DAVF, while the final diagnosis of DAVF is confirmed by DSA.关键词
硬脑膜动静脉瘘/颅颈结合区/数字减影血管造影/蛛网膜下腔出血Key words
Dural arteriovenous fistula/Craniocervical junction/Digital subtraction angiography/Subarachnoid hemorrhage
