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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Multiphase CT Angiography for Evaluation and Diagnosis of Complex Spinal Dural Arteriovenous Fistula
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Multiphase CT Angiography for Evaluation and Diagnosis of Complex Spinal Dural Arteriovenous Fistula

机译：复杂脊椎多云动静脉瘘评价与诊断的多相CT血管造影

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摘要

Spinal dural arteriovenous fistula (AVF) accounts for the majority of spinal vascular malformations (70%) and can lead to venous congestion with neurological injury. ' Spinal angiography is the gold standard for diagnosis. We present a case of tortuous, ectatic aorta with significant atherosclerosis preventing completion of successful spinal angiogram. Utilization of delayed multiphase computed tomography angiography (CTA) in patients with difficult to access vasculature provides a novel diagnostic and pre-therapeutic planning test for spinal dural AVF. The patient was an 85-year-old man with a 3-month history of bilateral lower extremity weakness and gait instability and found to have holocord edema on his thoracic MRI concerning for spinal dural AVF. On initial presentation, EMG demonstrated evidence of a distal, symmetric polyneuropathy in the bilateral lower extremities and a left-sided common peroneal neuropathy at the fibular head with axonal denervation. Two weeks later, the patient was admitted for frequent falls during exertion. He was also noted to have increased urinary frequency, decreased lower extremity sensation, and urinary incontinence. Medical history was pertinent for left-leg deep venous thromboembolism, hypertension, and hyperlipidemia.
机译：脊髓硬脑膜动静脉瘘（AVF）占脊髓血管畸形的绝大多数（70%），可导致静脉淤血并伴有神经损伤。”脊髓血管造影是诊断的金标准。我们报告一例主动脉迂曲扩张，伴有严重的动脉粥样硬化，阻碍了脊柱血管造影的成功完成。在难以获得血管系统的患者中使用延迟多相CT血管造影（CTA）为硬脑膜动静脉瘘提供了一种新的诊断和治疗前计划测试。患者是一名85岁男性，有3个月的双侧下肢无力和步态不稳病史，在其胸部MRI上发现与硬膜动静脉瘘有关的全脊髓水肿。在最初的表现中，肌电图显示双侧下肢远端对称性多发性神经病和腓骨头左侧腓总神经病变伴轴索失神经支配。两周后，患者因劳累时频繁跌倒而入院。他还注意到尿频增加、下肢感觉下降和尿失禁。病史与左腿深静脉血栓栓塞、高血压和高脂血症有关。

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