DIAGNOSIS AND TREATMENT OF PATIENTS WITH ARTERIOVENOUS MALFORMATIONS OF HEAD AND NECK USING 3D MULTIDETECTOR COMPUTER TOMOGRAPHY ANGIOGRAPHY

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Aim. The goal of our investigation was to optimize diagnosis and treatment of patients with arteriovenous malformations (AVM) of head and neck using 3D multidetector computer tomography angiography (MDCTA). Material and Methods. 24 patients aged 15-52 years (14 male and 10 female) with diagnosis extracranial AVM of different localization in head and neck region were examined and treated. Examination included clinical, laboratory, ultrasound diagnosis, MDCTA and digital subtraction angiography. Treatment plan was created individually in each case, based on the data gained by diagnostic procedures. Treatment options included surgical treatment, embolization of AVM or combined treatment. In certain cases several steps of treatment were planned. Patients were observed after treatment for 5 years. Results and Discussion. AVM were localized in one or several regions including frontal, temporal, palpebral, labial, nasal, submental, occipital, postauricular, infraorbital and buccal regions. Ultrasonography has shown a lesion with regular or irregular contours, heterogeneous structure with high and low echogenic sites. MDCT-angiography allowed to define size and depth of the lesion, vessel diameter, bone tissue involvement and participation of intracranial vessels in blood supply of the AVM. Combined treatment was performed in 17 cases (including embolization with surgical removal of AVM in 16 cases and electrochemical lysis and surgical removal of AVM in 1 case), and combined treatment was performed in 7 cases. Conclusions. Complementary diagnostic tools allow determining different parameters of AVMs that are necessary for treatment planning. Combined use of ultrasonography and 3D MSCTA provided precise treatment planning and helped to obtain good results.