血管数字减影步进技术在下肢动脉造影中的应用价值  

Applications of the digital subtraction angiography(DSA)stepping technology in the lower extremity arteriography

作　　者：宋烈军[1] 罗小平[1] 罗银灯[1] 汪景香[1] 

机构地区：[1]重庆医科大学附属第二医院放射介入中心,重庆400010

出　　处：《重庆医科大学学报》2009年第1期99-101,共3页Journal of Chongqing Medical University

摘　　要：目的：回顾性评价血管数字减影（Digital subtraction angiography，DSA）步进技术在下肢动脉造影中的可行性、作用及临床实用价值。方法：对我院2004～2005年的30例下肢动脉病变患者利用日本岛津1250MACCD数字x光机的步进技术实施DSA检查，自病变对侧股动脉穿刺、插管至病侧髂动脉后首先全程采集检查区各段蒙片相，以高压注射器经导管自病变侧髂动脉注射60％安其格那芬40ml（3ml/s）并同步、实时、一次性采集下肢各段动脉DSA图像。对照组50例下肢动脉实施分段、多次DSA检查。结果：研究组30例一次性获得满意DSA资料者87％（26／30），因注入对比剂引起疼痛导致被检肢体移动而未能一次性成功者13％（4／30）；研究组对比剂总用量30～50ml，平均40ml；造影曝光时间10～20S，平均12．5S。对照组50例，分段完成全部下肢动脉造影并满足诊断要求的造影次数为：4次35例、5次15例；对比剂总用量100～150ml，平均125．5ml；曝光时间50～100s，平均75．5s。结论：在下肢动脉造影中，血管数字减影步进技术大多可一次性获得满足诊断要求的影像资料，明显减少对比剂用量、缩短x线曝光时间而降低其损害，该技术优于分段造影方法，应作为肢体动脉造影的首选技术方法。Objective： To retrospectively evaluate the clinical applications and feasibility of stepping technology in the lower extremity arteriography. Methods： Between 2004 and 2005, thirty patients with arteriopathy of lower extremity in our hospital received arteriography by using the stepping technology with a Shimadzu 1250 mA DSA. First, mask images of all interested parts were acquired after catheterizing to the affected iliac artery via the contralateral femoral ateriopuncture.Then using power injector, we injected diatrizoate meglumine （60% Angiografin） 40 ml （rate： 3 ml/s ）into the illed ilac artery, meanwhile synchronous and real-time images of every interested segment of the artery were filmed at one time. The control group consisted of fifty patients with the arteriopathy of the lower extrmety and underwent DSA segmently and repeatedly. Results： Of 30 patients, 26（87%） in the study group had gained images met the diagnostic requirments in one examination. And 4 patients（ 13% ） with unsatisfactory images due to pain caused by the injection. The total constrast medium was between 30 and 50 ml （mean amount 40 ml）, and the exposure time was between 10 s and 20 s（mean time 12.5 s）. In order to reach the diagnostic requirments, 35 patients in control group were examined 4 times, and other 15 patients underwent the examination 5 times. The total constrast medium was between 100 and 150 ml （mean amount 125.5 ml）, and the exposure time was between 50 and 100 s （ mean time 75.5 s ）. Conclusion： Stepping technology in the lower extremity arteriography is better than segmental angiography in providing ideal images acquired in one examination to meet the diagnostic requirments. It spends lower total constrast medium and has shorter exposure time. It should be the first-line technique in the extremity arteriography.

关 键 词：肢体动脉造影 DSA 步进技术 

分 类 号：R816.2[医药卫生—放射医学]