ABSTRACT
Objective To evaluate the accuracy and clinical efficacy of low field phase-contrast magnetic resonance angiography(PC-MRA),CTA and 3D-DSA in the diagnosis of cerebrovascular disease.Methods 70 patients with clinically suspected cerebrovascular diseases were examined with PC-MRA,CTA and 3D-DSA.The sensitivity in detecting the cerebrovascular disease with these three methods were compared.Results Fifty-one patients were detected with cerebrovascular diseases in seventy patients by three imaging methods,including 36 aneurysms in 33 cases and 18 arteriovenous amlformations.33,34 and 35 aneurysms,17,16 and 18 arteriovenous malformations were detected by PC-MRA , CTA and 3D-DSA respectively , the sensitivity were 91.67% and 94.44%,94.44% and 88.89%,97.22% and 100% respectively.There were no significant difference in the sensitivity of detecting aneurysm and arteriovenous malformation between these three imaging methods(P＞0.05).Conclusion PC-MRA,CTA and 3D-DSA are no of difference in diagnosis of cerebrovascular malformation.
ABSTRACT
The application of stereotactic radiosurgery for cerebrovascular malformations began in the early 1970s. Despite pooly documented response of vascular malformations to externally fractionated radiotherapy, single fraction, high dose, small-field, focused irradiation of small vascular malformations were found to be effective and non-invasive method to obliterate vascular malformations. During last thirty years, overall role of stereotactic radiosurgery has been established in the management of carefully selected vascular malformations. By 1998 world-wide, more than 20,000 patients had undergone Gamma Knife radiosurgery for arteriovenous malformations. In comparison to other forms of nonsurgical management or surgical excision, stereotactic radiosurgery has number of advantages. In properly selected, small volume AVMs, the total obliteration rate at two years appears to be acceptably high(more than 80%), and is associated with low morbidity(less than 2-3%). In contrast to open surgical removal, radiosurgery is associated with none of the risk of microsurgical resection such as blood loss, infection, acute neurological deficits and operative mortality. And yet, major problem of radiosurgery is that it is still exposed to any potential risk of bleeding during latent period before complete obliteration of arteriovenous malformations. Continuous study and researches are recommended for radiobiological clearance. To solve this problem and to enhance the effectiveness of treatment, new energy source should be developed to reduce latent period until complete obliteration would be secured, while reducing the chance of risk by irradiation. Presently, radiosurgery is applied to other vascular malformations such as cavernous angioma or venous angioma, yet, the result is still subject to controversy. Thus, more rigorous research, clinical experience, and enhanced treatment plan should be sought.