含钆对比剂在脑血管DSA介入检查或治疗中的应用  

Application of contrast medium contained gadolinium in interventional examination and therapy for cerebrovascular DSA

作　　者：王金龙[1] 凌锋[1] 李慎茂[1] 宋庆斌[1] 黄居义[1] 王玉林[1] 吴婷夏[1] 

机构地区：[1]首都医科大学宣武医院介入中心,北京100053

出　　处：《医学影像学杂志》2007年第9期899-901,共3页Journal of Medical Imaging

摘　　要：目的:探讨Gd-DTPA作为对比剂在脑血管DSA介入检查或治疗中的应用价值。方法:对28例碘剂禁用者应用钆喷酸葡胺作为对比剂进行脑血管DSA介入检查或治疗,另外随机抽取28例应用非离子型碘水对比剂作为对照组进行脑血管DSA介入检查或治疗。两组病例对比剂的注射量、注射流率及压力限制保护均相同,通过对相关血管DSA图像显示结果进行对照分析,揭示含钆对比剂在脑血管DSA介入检查或治疗中的应用价值,寻求改善钆对比剂脑血管DSA图像质量的途径。结果:应用Gd-DTPA作为对比剂进行脑血管DSA介入检查或治疗,与应用非离子型碘水对比剂相比较,由于含钆对比剂的钆离子浓度低,其图像质量略差于使用非离子碘水对比剂图像,脑部相关血管主干显示无明显差异,对于终末细小分枝的显示,碘水对比剂影像质量优于含钆对比剂。通过以下措施来改善影像质量,从而获得满意图像:①改变图像采集时DSA设备的管电压值:将应用碘水对比剂时的66～70kV提高到75～80kV;②调整窗宽、窗位数值:将窗宽值由930降至900,将窗位值由50升至75,提高图像的对比度和降低图像亮度;③调整图像滤过参数、边缘增强指数:提高滤过参数至100%;边缘增强指数由4升至5。结论:在对碘剂禁用者中使用Gd-DTPA进行脑血管DSA介入检查或治疗,能够显示脑部相关血管影像,可以满足脑血管病的诊断及介入治疗需要。Objective. To study the application of Gd-DTPA as Contrast medium in interventional examination and therapy for cerehrovascular DSA.Methods：28 cases, who were prohibited using iodine, were used Magnevist Sohtion as Contrast medium in the interventional examination and therapy for cerebrovascular DSA, and other 28 cases randomly collected as a control group were injected non- ionic iodine Contrast medium. It was the same as for the injected dose, injected speed and pressure limitation protected between two groups. To research the value of Contrast medium contained gadolinium in interventional examination and therapy for cerebrovascular DSA by cross-check analyzing the related vascular DSA and to explore the way that improve the quality of images of eerebrovascular DSA that use Gd-DTPA.Results：To compare with non-ionic iodinecontrast medium, Gd-DTPA, as Contrast medium in interventional examination and therapy for cerebrovascular DSA, had a little degression on the quality of images for low density, but had no obviously difference in the vascular bole d brain, anyway, images of non-ioniciodine were surpass Gd-DTPA showing the terminal branches. We can improve the quality of images by some ways,and obtain the good images： （1） To elevate the tube tension humerus of DSA equip from 66- 70kV to 75 - 80kV when we collected images; （2） To adjust window width from 930 to 900, and window levd from 50 to 75, improve image contrast and degrade image brightness; （3） To elevate faltered parameter to 100%, edge enhancement index from 4 to 5. Conclusion：Using Gd- DTPA to those who were prohibited using iodine in the interventional examination and therapy for cerebrovascular DSA, can display the xelated vascular images in the brain, and provide the help for the diagnosis and interventional therapy of cerebrovascular diseases.

关 键 词：Gd-DTPA 对比剂 数字减影血管造影 脑血管病 放射学 介入性 

分 类 号：R743[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]