Abstract:

Objective　To investigate the clinical presentations, imaging features, and treatment of spinal dural arteriovenous fistula (SDAVF). Methods　29 patients with SDAVF trented at Department of Neurology and Department of Neurosurgery, Chinese PLA General Hospital from February 2015 to April 2021 were selected for this retrospective study. The patients were averagely 60.93 years old. The disease course was 20 d to 38 months. The patients' medical history, the clinical features, and results of digital subtraction angiography (DSA) and spinal magnetic resonance imaging (MRI) were collected. Results　Among the 29 patients, 21 cases had lower limb weakness, 16 aching and numbness of limbs, 13 bladder or bowel disfunction, 3 waist and back pain, and 3 others symptoms; 7 cases aggravated after treatment with glucocorticosteroid. DSA and spinal MRI were performed to determine the location of fistula. Two cases had fistula on the cervical segment,21 the thoracic segment, 1 the thoracolumbar segment, 4 the lumbar segment, and 1 the lumbosacral segment. Six cases took interventional embolization, and 23 surgery. Conclusions　SDAVF is a rare spinal vascular malformation, with a variety of clinical manifestations. DSA is the golden standard for its diagnosis. Early diagnosis and treatment can significantly improve the patients' prognosis.

Key words:

Spinal dural arteriovenous fistula, Clinical features, Imaging features, Treatment

摘要：

目的　探讨硬脊膜动静脉瘘（SDAVF）的临床表现、影像特征和治疗。方法　本研究采用回顾性分析，选取2015年2月至2021年4月解放军总医院第一医学中心神经内科及神经外科收治的29例SDAVF患者，其中男24例、女5例，平均年龄60.93岁，病程20 d～38个月。收集患者的病史特点、临床特征、数字减影血管造影（DSA）及脊髓磁共振成像（MRI）结果。结果　29例SDAVF患者临床表现为双下肢无力21例，肢体麻木和疼痛16例，尿便功能障碍13例，腰背部疼痛3例，其他症状3例。其中7例采用糖皮质激素治疗后症状加重。通过DSA、脊髓MRI检查确定瘘口位置：颈段2例，胸段21例，胸腰段1例，腰段4例，腰骶段1例。6例接受了介入栓塞治疗，23例进行外科手术治疗。结论　SDAVF临床表现多样化，DSA是确诊SDAVF的金标准，及早诊断与治疗能够显著改善预后。

关键词:

硬脊膜动静脉瘘, 临床特征, 影像学特点, 治疗