目的 提高对创伤性假性动脉瘤并动静脉瘘的影像诊断水平。 方法 报告1例腰椎间盘手术所致的创伤性假性动脉瘤并动静脉瘘，比较分析MRA和DSA对该病的诊断价值。 结果 MRA能够明确创伤性假性动脉瘤及动静脉瘘的诊断，与DSA有良好的相关性。 结论 MRA对创伤性假性动脉瘤并动静脉瘘的确诊有重要价值，在一定程度上能够代替常规血管造影。
目的阐明数字减影血管造影（DSA）监控在区域性置管栓塞化疗治疗肝癌中的重要性。方法比较152例肝癌区域性置管中DSA监控置管与注射美蓝指导下置管的导管位置准确性； 并对术后发生与置管有关的并发症进行分析。结果DSA监控置管准确率肝动脉及门静脉均为100%，注射美蓝指导下置管肝动脉和门静脉的导管位置准确率分别为70.2%和76.1%，两组比较差异有显著性意义（P＜0.01)。术后有导管移位、肝动脉胆管瘘、导管阻塞、药液外漏、硬化性胆管炎等并发症。结论DSA指导下置管准确，又能保证血管内介入治疗的彻底性； 术后行DSA监控，以指导下一步的治疗，并可防止并发症的发生。
Objective To compare the bronchial arteriography through multidetector-row CT (MDCT) with the digital subtraction angiography (DSA) via femoral artery, and evaluate the application value of bronchial arteriography through MDCT in the diagnosis and treatment of hemoptysis. Methods 133 cases complained of hemoptysis were examined by MDCT and DSA via femoral artery respectively to perform bronchial arteriography, and the differences of image results by two methods were compared. Results 129 cases with abnormal bronchial arteries were confirmed by DSA via femoral artery, 117 cases were checked by MDCT [ the positive rate was 90.7% (117/129 ) ] . 117 cases with abnormal bronchial arteries were confirmed by both MDCT and DSA via femoral artery and 4 cases did not detected any abnormal arteries by both methods. The coincidence rate of two methods was 91.0% (121 /133) . MDCT and DSA via femoral artery showed the similar origins of abnormal bronchial arteries. The coincidence rate of two methods was 100% . Conclusions There is a high coincidence rate betweenMDCT and DSA in detecting bronchial artery abnormalities. MDCT shows the origins of abnormal vessels clearly which could be a fist-choice of routine imagination for interventive operation.
Objective To observe the complication after embolizing the bilateral internal il iac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety appl ication of gelfoam in cl inic. Methods Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2females) were randomly divided into 5 groups. Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 μm) in bilateral internal il iac arteries and the main branch of the median sacral artery (group A, n=3), in bilateral internal il iac arteries and the first branch of the median sacral artery (group B, n=3), in the main branch of bilateral internal il iac arteries (group C, n=3), in the unilateral internal il iac artery and the main branch of the median sacral artery (group D, n=4), and in the main branch of unilateral internal il iac artery (group E, n=3). Under the DSA, the anatomic relationships of the abdominal aorta, bilateral external il iac arteries, bilateral internal il iac arteries, and median sacral artery were observed before embol ization. The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization. Results In dogs, there was no common il iac artery; bilateral external il iac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation. Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment. In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL. In survival dogs, no obvious change was observed in the rectum; the bladder only manifested l ight edema; and the median urinary volume in bladder was 137.0, 220.5, and 28.0 mL, respectively in groups B, D, and E.The rectum and bladder of dead dogs in groups A, C, and D manifested the disrupted cells, generous inflammatory cells infiltration, and desquamation of epithel ial cells; the rectum and bladder of survival dogs in groups B, D, and E manifested l ight inflammatory cells infiltration and edema; the embol ized artery mainly focused on the arterioles whose diameter was 100-200 μm. The sciatic nerve and gluteal muscles of each group had no obvious change except for l ight edema. Conclusion When the internal il iac artery and median sacral artery are embol ized with gelfoam particle with a diameter of 50-150 μm, to ensure the safeness of pelvic organs, the embol ized artery can not exceed the first branch when the 3 arteries are embol ized at the same time, or reserve at least unilateral internal il iac artery when embol ized to the trunk , or it will result in pelvic organ necrosis and perforation.
Objective To observe the digital subtraction angiography (DSA) characteristics of ophthalmic artery and its main branches in ischemic cerebrovascular disease (ICVD). Methods The internal carotid arteries, external carotid arteries and ophthalmic arteries of 32 ICVD patients were examined for DSA. The characteristics of ophthalmic artery origin, trail and main branches were observed. Results Among 64 carotid arteries of 32 patients, there was one carotid artery with internal occlusion, there was no severe stenosis in the other 63 carotid arteries. The 63 ophthalmic arteries originated all from supraclinoidal and ophthalmic segments of internal carotid arteries. 58 ophthalmic arteries were single branch from the internal carotid artery. 5 ophthalmic arteries had 2 branches, one come from the internal carotid artery, the other come from the middle meningeal artery (external carotid artery branch ) in 4 cases or from the anterior cerebral artery (carotid artery branch) in 1 case. The main branches of ophthalmic artery included central retinal artery, posterior ciliary artery, lacrimal gland artery, ocular muscular artery; anterior ethmoid artery, posterior ethmoid artery, supraorbital artery, dorsal nasal artery, supratrochlear artery and eyelid artery. The beginning point of each branches were variable. Conclusions Ophthalmic arteries of ICVD patients primary arise from the internal carotid artery. It most often appears as single branch and occasionally as double branches. The beginning points of major branches of ophthalmic artery are variable.
【摘要】目的探讨在数字减影 (DSA)透视下,经过鼻腔将胃管、空肠营养管联合置入及其临床应用的范围和价值。方法选择2007年8月23日2009年10月22日期间35例需要行肠内营养的患者,在DSA透视下经鼻腔将胃管以及预先套入的空肠营养管联合置入,置管成功后分别造影,显示胃管位于胃内,而空肠营养管末端位于空肠内。结果35例患者成功置管。置管时间为49～186 min,平均108 min。置管中及置管后未发生严重并发症。置管后营养管在位良好,喂养过程顺利。结论DSA透视下经鼻胃管、空肠营养管联合置入是一种安全、经济、有效的肠内营养途径,同时解决了胃液引流问题,具有一定的临床应用价值。
目的:以数字减影血管造影(DSA)为手段,分析短暂性脑缺血发作(TIA)患者临床特点及脑供血动脉狭窄或闭塞的发生率。方法:对 2003 年1月至2007 年8 月期间四川大学华西医院神经内科收治且行DSA检查的短暂性缺血发作患者 65 例进行研究。对患者临床特点,动脉病变情况﹑狭窄程度进行分析.结果:65 例TIA患者中发现血管病变有 38 例(58.5%),其中单侧受累 14 例(21.5%),多处受累 24 例(36.9%),中度及重度,闭塞的血管狭窄多见,且多发生在颅外段。结论:DSA可以明确TIA病患者中血管动脉粥样硬化,狭窄程度,这对指导治疗起重要作用。
ObjectiveTo analysis the risk factors for carotid stenosis in patients with ischemic cerebrovascular disease based on digital subtraction angiography. MethodsA total of 312 patients diagnosed with ischemic cerebrovascular disease who underwent digital subtraction angiography from June 2011 to September 2013 were selected.The risk factors of carotid stenosis were analysised by multivariate logistic regression analysis. ResultsIn 312 patients,271 were with cerebral infarction and 41 were transient ischemic attack patients.There were 149 patients in carotid stenosis group (stenosis degree ≥50%) and 163 patients in control group (stenosis degree<50%).The age (OR=1.037,P=0.000) and coronary heart disease (OR=4.121,P=0.001) were independent risk factors of carotid stenosis with ischemic cerebrovascular disease. ConclusionCarotid stenosis is common in ischemic cerebrovascular disease.Age and coronary heart disease were the independent risk factors.The recognition and control of these risk factors are in favor of secondary prevention of ischemic cerebrovascular disease.