Abstract：Objective: To explore the value of CT spinal angiography in diagnosing spinal cord vascular malformation by 64-detector row spiral CT. Methods: Seventeen patients with initial MR and clinical findings suggestive of spinal vascular diseases underwent CT spinal angiography. Among these, 14 patients were performed DSA later within 1 week, and 7 patients underwent surgical treatment, 6 patients underwent vascular intervention embolotherapy. CT protocol: Toshiba Aquilion 64 Slice CT scanner, 0.5mm thickness, 0.5/r, 120kV, 350mA, choose aortic arch level as inspection position, and use “sure start” technique with CT threshold 180HU. Contrast medium was Iohexol(370mgI/ml), injection velocity 6ml/s, total volume 80ml. CT spinal angiography were evaluated based on disease typing, disease range, feeding arteries, fistulas, draining veins of vascular malformation and compared with DSA and operation results. Results: All of the 17 patients showed clearly the abnormality of spinal cord vessels and the range of lesions by CT spinal angiography. Among them, one patient was diagnosed as arteriovenous fistulas(AVF) by MRI and CT spinal angiography, which was verified by surgical operation. However, DSA didn’t visualize the lesion. One case was diagnosed as AVM complicated with AVF by DSA, but CT spinal angiography could only show AVM, and didn’t visualize AVF. The typing of all the other 16 patients agreed with DSA. Thirteen cases which obtained positive results of CT spinal angiography and DSA displayed 20 feeding vessels. Among them, 16 vessels were displayed correctly by CT spinal angiography, 4 vessels were not visualized, and 2 false-positive results were obtained. Fistulas were not shown in six cases by CT spinal angiography. Draining veins were displayed clearly in all cases, and agreed with DSA. Conclusion: There are great values for CT spinal angiography in diagnosing vascular malformation of spinal cord. It can be a screening exam before DSA, and has a guiding effect on DSA, reducing the amount of time required for DSA.
2008, Vol. 19 
