Cerebral Arteriovenous Malformations in Children: Neuroimaging Findings

兒童腦內動靜脈畸形之神經影響表現

勞允澤(Wan-Chak Lo) ； 王超然(Chao-Ran Wang) ； 林坤榮(Kun-Egn Lim)

《Acta Paediatrica Sinica》 38卷4期 (1997/08) Pp. 288-292

https://doi.org/10.7097/APS.199708.0288

摘要

雖然腦內動靜脈畸形所引發的病變不常發生於兒童，但腦內動靜脈畸形是兒童腦內血管病變最常出現的病變，出現時臨床症狀也較嚴重。從民國八十四年九月至八十五年十二月共收集13例病人（年齡少於16歲之病患），在神經放射線學方面，他們經由腦血管攝影被診斷為腦內動靜脈畸形。全部13例都曾作腦部電腦斷層，其中有7例曾作腦內磁振造影，2例作腦部電腦內磁振血管造影并加以分析討論。病灶大多發生於兩側大腦半球，4例在囁葉，2例在頂葉，3例在額葉，2例在枕葉，3例在胼胝體，1例混合型含2個病灶，分別在額葉和胼胝體。至於臨床表現以腦內溢血為主，其次是抽慉表現。根據吾人的經驗，診斷腦部動靜脈畸形，在神經放射線學方面，磁振造影及磁振血管造影可以清楚地把動靜脈畸形之病灶表現出來，比傳統電腦斷層可靠準确，也適合放射治療後病灶變化的追蹤，因為病人不需要接受動脈穿刺及注射造影劑，故較傳統動脈血管攝影安全及舒適。然而腦部血管攝影仍有它獨特之好處，特別在分析血管病變及血液動力學方面。

關鍵字

腦內動靜脈畸形 ； 電腦斷層 ； 磁振造影 ； 磁振血管造影 ； 腦部血管攝影

並列摘要

Cerebral arteriovenous malformations (CAVMs) are uncommon in children. CAVMs represent the most frequent intracranial vascular pathology at pediatric ages. This report concerns 13 children below the age of 16; all were identified between September 1995 and December 1996 with 14 CAVMs among them. All were proved by conventional cerebral angiography (CCA). Thirteen computed tomography (CT), 7 magnetic resonance images (MRI), 2 magnetic resonance angiography (MRA) and 13 conventional cerebral angiography (CCA) were analyzed. Most CAVMs nidus were located in cerebral hemispheres. Four in the temporal lobe, two in the parietal lobe, three in the frontal lobe, two in the occipital lobe, and three in the corpus callosum. One of them was of a mixed type with two nidi. The major clinical features of CAVMs were intracranial hemorrhage and seizures. Experience here was that MRI is superior to CT in showing the exact anatomic relationships of the nidus and in demonstrating the extent of CAVMs nidus obliteration after treatment. MRA provided a noninvasive means of studying blood vessels and vascular pathology in relationship to the CA VMs nidus. Standard angiography is still necessary to characterize in-flow and out-flow of vessels in CAVMs when definitive treatment is considered.

並列關鍵字

cerebral arteriovenous malformations ； computed tomography ； magnetic resonance image ； magnetic resonance angiography ； cerebral angiography