髓周动静脉瘘（PMAVF）一例及文献复习.

Objective: To increase the awareness of perimedullary arteriovenous fistulas (PMAVF) by investigating the clinical and imaging characteristics as well as treatment options of the disease. Methods: The diagnosis and treatment of a patient with PMAVF were reported. A summary of the clinical and imaging characteristics as well as treatment modalities of the disease was made based on literatures. Methods: One patient presented with progressive lower limb numbness accompanied by weakness, and gradually developed incontinence. MRI of thoracic and lumbar segments showed obvious tortuosity and dilatation of perimedullary artery near the ninth thoracic vertebrae level. The examination of spinal angiography (DSA) showed that the anterior spinal artery from the right thoracic 9 intercostal artery at the level of the thoracic 12 vertebra supplied an abnormal drainage venous mass at the right side of the spine. The patient underwent curative embolization of draining veins and fistula with OnyxR. glue embolization. Muscle strengths of the lower limbs recovered to scale 4 one year post-operation. Conclusion: Most of the early clinical manifestations of PMAVF are not specific and then progressive myelopathy gradually appears. Spinal MRI plays an important role in the diagnosis of PMAVF. CT angiography and contrast-enhanced MR angiography (ceMRA) of the spinal cord are helpful to determine the location of fistula before operation. Digital subtraction angiography (DSA) is still the gold standard for the diagnosis of the disease. Surgical resection and endovascular therapy are two main modalities to treat this disease. [ABSTRACT FROM AUTHOR]