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脊髓AVM由多条动脉供血,多条静脉引流,位于颈段的AVM还可通过脑静脉窦回流。脊髓AVM最早发生在胎龄3周前,据血管构筑学可细分为终末型供血型、穿支供血型、动静脉直接交通、AVM伴有动脉瘤及AVM伴有静脉动脉瘤样扩张五类,根据不同类型选择相应治疗方法。脑AVM的供血动脉及回流静较少,神经外科对脑AVM常用SpetzlerMartin分类法,在放射学领域则采取其它分类。极少数患者出现畸形团的自发闭塞,但未能排除闭塞畸形团再通的可能,故对这些患者还须定期随访。今后当加强脊髓AVM的血管构筑学研究,更新理念。血管构筑学并非只依赖解剖、放射等学科的形态学,还应重视流动血液与周围组织的影响,与血液流变学、血流动力学等结合,改进观察手段,变单维为多维,变静态为动态,并开展前瞻随机对照研究,成为一门动态的、更完善、更明确的学科。
Spinal cord AVM by a number of arteries, multiple venous drainage, located in the cervical AVM can also be refluxed through the cerebral venous sinus. Spinal cord AVM first occurred in gestational age 3 weeks ago, according to vascular architecture can be subdivided into terminal blood supply type, perfused branch blood supply, arteriovenous direct traffic, AVM with aneurysms and AVM accompanied by venous aneurysm-like expansion of five Class, according to different types of choice of the appropriate treatment. Cerebral AVM feeding artery and return less static, neurosurgery on the AVM commonly used SpetzlerMartin classification, in the field of radiology to take other categories. A very small number of patients with spontaneous occlusion of abnormal occlusion, but failed to rule out the possibility of recurrent deformity regiment, so these patients also need regular follow-up. In the future to strengthen spinal cord AVM vascular architecture research, update the concept. Vascular architecture is not only dependent on the morphology of disciplines such as anatomy and radiology. It should also pay attention to the influence of mobile blood and surrounding tissues, to combine with hemorheology and hemodynamics, to improve observation methods, to change single dimension into multidimensional and variable Static as dynamic, and carry out prospective randomized controlled study, become a dynamic, more perfect, more clear discipline.