摘要目的 探讨静息态病灶内微出血(SIM)与脑动静脉畸形(bAVM)破裂出血的相关性.方法 收集天坛医院神经外科自2014年9月至2016年9月收治的63例bAVM患者的临床及病理学资料[应用影像学陈旧性出血证据(EOOH)和病理学含铁血黄素普鲁士蓝染色作为SIM的证据],采用多因素Logistic回归分析,校正性别、年龄、病变体积、供血动脉数量、是否引流至深静脉等因素后,评估影像学EOOH及普鲁士蓝染色结果与bAVM破裂出血的相关性. 结果 bAVM破裂出血与性别、年龄、病变体积无关,与供血动脉数量、是否引流至深静脉、影像学EOOH(OR=5.507,95％CI:1.208～25.111,P=0.028)及普鲁士蓝染色结果(OR=6.055,95％CI:1.479～24.793,P=0.012)显著相关. 结论 影像学EOOH是bAVM破裂出血的潜在预测标志.

abstractsObjective To investigate the association between silent intralesional micro-hemorrhage (SIM) and symptomatic intracranial hemorrhage (ICH) of brain arteriovenous malformations (bAVMs) by using evidence of old hemorrhage (EOOH) and hemosiderin dyeing results.Methods Sixty-three patients with bAVMs,admitted to our hospital firom September 2014 to September 2016,were chosen in our study;their clinical and pathological data were retrospectively analyzed.Logistic regression analysis was performed to assess the correlations of ICH of bAVMs with EOOH and Prussian blue staining results after adjusting the factors as gender,age,lesion size,location,single or multiple supplying arteries and deep venous drainage.Results Gender,age,lesion size were not associated with ICH of bAVMs,while single or multiple supplying arteries,deep venous drainage and SIM were significantly associated with ICH ofbAVMs.EOOH and Prussian blue staining results were the independent predictors of ICH ofbAVMs (OR=5.507,95％CI:1.208-25.111,P=0.028;OR=6.055,95％ CI:1.479-24.793,P=0.012).Conclusion ICH of bAVMs could be proved by EOOH and hemosiderin,and EOOH could serve as a potential predictor ofICH ofbAVMs.