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首页> 外文期刊>Neurosurgery >Pretreatment and posttreatment evaluation of hemodynamic and metabolic parameters in intracranial dural arteriovenous fistulae with cortical venous reflux.
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Pretreatment and posttreatment evaluation of hemodynamic and metabolic parameters in intracranial dural arteriovenous fistulae with cortical venous reflux.

机译：颅内硬脑膜动静脉瘘伴皮质静脉返流的血流动力学和代谢参数的预处理和后处理。

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OBJECTIVE: Retrograde drainage into the cortical veins results in poor outcome in patients with an intracranial dural arteriovenous fistula. However, the pathophysiological features of dural arteriovenous fistulae remain obscure. This study aimed to clarify hemodynamic and metabolic conditions in these patients using positron emission tomography. METHODS: This study included eight patients with an intracranial dural arteriovenous fistula. All patients had cortical venous reflux, as demonstrated by angiography. Regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional cerebral metabolic rate for oxygen, and regional oxygen extraction fraction (rOEF) were measured before and after surgical or endovascular treatment using positron emission tomography. RESULTS: Pretreatment positron emission tomographic studies revealed that all patients had abnormal hemodynamic and metabolic parameters in the area that was drained by the involved cortical veins. A severe increase in rCBV was noted in seven of the eight patients. A significant decrease in rCBF also was observed in all eight patients. A negative correlation was observed between rCBF and rCBV. Three patients had an elevated rOEF. Oxygen metabolism was impaired in seven patients. All patients underwent successful treatment. Follow-up studies demonstrated significant improvements in rCBF, rCBV, and regional cerebral metabolic rate for oxygen. The improvement in regional cerebral metabolic rate for oxygen varied among the patients. Normalization of rOEF also was confirmed in three patients who had increased rOEF before the treatment. CONCLUSION: The present results suggest that hemodynamic and metabolic characteristics vary widely among patients with cortical venous reflux. It is essential to precisely evaluate hemodynamic and metabolic conditions to predict their outcomes and therapeutic effects.
机译：目的：向颅内硬脑膜动静脉瘘行逆行引流进入皮质静脉会导致预后不良。然而，硬脑膜动静脉瘘的病理生理特征仍然不清楚。这项研究旨在使用正电子发射断层扫描来阐明这些患者的血液动力学和代谢状况。方法：该研究纳入了8例颅内硬脑膜动静脉瘘患者。如血管造影所证实，所有患者均有皮质静脉回流。使用正电子发射断层扫描术在手术或血管内治疗前后分别测量区域性脑血流量（rCBF），区域性脑血容量（rCBV），区域性氧代谢率和区域性氧提取率（rOEF）。结果：治疗前的正电子发射断层扫描研究表明，所有患者在皮层静脉引流区域均具有异常的血液动力学和代谢参数。八名患者中有七名患者的rCBV严重升高。在所有八名患者中也观察到rCBF显着降低。在rCBF和rCBV之间观察到负相关。 3例患者的rOEF升高。七名患者的氧气代谢受损。所有患者均接受了成功的治疗。后续研究表明，氧的rCBF，rCBV和局部脑代谢率显着改善。氧的局部脑代谢率的改善因患者而异。在治疗前增加rOEF的三名患者中也证实了rOEF的正常化。结论：目前的结果表明，皮质静脉反流患者的血流动力学和代谢特征差异很大。精确评估血液动力学和代谢状况以预测其结果和治疗效果至关重要。

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