Application Of Multislice Computed Tomography Angiography In Diagnosis And Treatment Of Cerebral Arteriovenous Malformation

Application Of Multislice Computed Tomography Angiography In Diagnosis And Treatment Of cerebral arteriovenous malformationAbstract:objective:To evaluate the application of multislice spiral computed tomography angiography (MSCTA) In the diagnosis and postoperative evaluation of cerebral arteriovenous malformations.Methods:from 2007.09 to 2009.03,32 patients who were diagnosed with cerebral arteriovenous malformations by DSA in the neurosurgery department of Affiliated Hospital of Luzhou Medical College. The patient were scaned by The 64-slice spiral CT for the arterial phase and venous phase scan. Then transfer the data to AW4.3 post-processing workstation. Use Add/Sub software to obtained three groups subtraction date:①useing the arterial phase scan data minus scan data to acquire arterial subtraction data;②useing venous phase scan data minus scan data to acquire mixed arterial and venous subtraction data;③useing venous phase scan data minus the arterial phasescan data to acquire venous subtraction data.Using volume rendering (Volume rendering, VR), thin maximum intensity projection (Thin-slab intensity projection, TSMIP) reconstructed image. The minimum threshold of VR is 25-100 Hu, and the largest is 600Hu, Thickness of TSMIP is 15mm. Reconstruct arterial subtraction image with arterial subtraction data.Reconstruct mixed arterial and venous subtraction data image with mixed arterial and venous subtraction data. Reconstruct venous subtraction data image with venous phase scan data. Reconstruct arterial subtraction image with arterial subtraction data.Reconstruct mixed arterial and venous subtraction data image with mixed arterial and venous subtraction data. Reconstruct venous subtraction data image with venous phase scan data. Reconstruct arterial unsubtracted image with arterial phase scan data. Reconstruct mixed arterial and venous unsubtracted image with venous phase scan data. Reconstruct arterial subtraction image with arterial subtraction data Reconstruct mixed arterial and venous subtraction data image with mixed arterial and venous subtraction data. Reconstruct venous subtraction data image with venous phase scan data. Reconstruct arterial unsubtracted image with arterial phase scan data. Reconstruct mixed arterial and venous unsubtracted image with venous phase scan data,and then remove artery by using the Software with mixed arterial and venous image to acquire venous unsubtracted image. All unsubtracted image Including the image of bones.Observed imaging effects, the source, quantity,site of blood supply artery of cerebral arteriovenous malformations and the position,the size,the depth of drainage vein of cerebral arteriovenous malformations.Results:1.32 cases of cerebral arteriovenous malformation were diagnosised by DSA which missed 0.31 cases of cerebral arteriovenous malformation were diagnosised by MSCTA which missed 1.2. The position of 30 cases of this group of supratentorial cerebral arteriovenous malformation are above tentorium of cerebellum,and 2 case below tentorium of cerebellum. There are frontal lobe arteriovenous malformation in 6 cases, parietal lobe arteriovenous malformation in 5 cases,occipital arteriovenous malformation in 4 cases, the parietal-occipital arteriovenous malformation in 3 cases, lateral cleft arteriovenous malformations in 3 cases, frontal-parietal lobe arteriovenous malformation in 2 cases, temporal-parietal arteriovenous malformations in 2 cases, temporal lobe arteriovenous malformation in 2 cases, arteriovenous malformations of the corpus callosum in 1 case, arteriovenous malformation of hypothalamus in 1 case, cerebellum hemisphere arteriovenous malformation in 2 cases, brain stem arteriovenous malformations in 1 case. There are frontal lobe arteriovenous malformation in 6 cases,parietal lobe arteriovenous malformation in 5 cases,occipital arteriovenous malformation in 4 cases, the parietal-occipital arteriovenous malformation in 3 cases, lateral cleft arteriovenous malformations in 3 cases,frontal-parietal lobe arteriovenous malformation in 2 cases, temporal-parietal arteriovenous malformations in 2 cases, temporal lobe arteriovenous malformation in 2 cases, arteriovenous malformations of the corpus callosum in 1 case, arteriovenous malformation of hypothalamus in 1 case, cerebellum hemisphere arteriovenous malformation in 2 cases, brain stem arteriovenous malformations in 1 case. There are a single feeding artery in 13 cases, two artery in 19 cases and above; one superficial venous drainage in 29 cases,3 cases of deep venous drainage.3.MSCTA can show the source, quantity, site of blood supply artery of cerebral arteriovenous malformations and the position,the size,the depth of drainage vein of cerebral arteriovenous malformations accurately. Conclusion:1.There is no difference between DSA and MSCTA which is used on diagnosising cerebral arteriovenous malformation.2.MSCTA can provide a wealth of valuable information for clinicians。Clinicians choose the best treatment relying on this information.3.MSCTA can show the source, quantity,site of blood supply artery of cerebral arteriovenous malformations and the position,the size,the depth of drainage vein of cerebral arteriovenous malformations accurately. And designs the operative approach precisely for clinician.4.MSCTA with its non-invasive, simple, less time-consuming checks,low cost, imaging three-dimensional effect, and can be inspected for hemorrhage and other advantages, is welcomed by clinicians and patients greatly.