动静脉内瘘功能不全多排CT全景血管成像应用  

Autogenous arteriovenous fistula dysfunction: multi-slice spiral CT panoramic angiography and its clinical value

作　　者：张小胜[1] 彭飞[1] 黄德健[1] 宋进华[2] 顾建平[2] 

机构地区：[1]江苏省中西医结合医院放射科,南京210028 [2]南京医科大学附属南京医院介入科

出　　处：《介入放射学杂志》2014年第11期945-949,共5页Journal of Interventional Radiology

摘　　要：目的探讨血液透析患者自体动静脉内瘘功能不全的多排螺旋CT全景血管成像及其临床应用价值。方法对32例自体动静脉内瘘功能不全患者的透析通路进行64排螺旋CT扫描,分别完成多平面重建、曲面重建、最大密度投影、容积再现、血管自动去骨全景血管成像。结果所有病例均清晰地显示内瘘侧上肢血管情况以及与周围组织结构的空间关系,明确动静脉内瘘功能不全的责任血管,临床采取不同的干预手段,有30例通过手术重新建立透析通路,2例通过非手术治疗而改善了透析流量。结论全景血管成像可以较好的显示透析通路的病变血管,对临床干预具有较大指导价值。Objective To explore the panoramic vascular imaging of autologous arteriovenous fistula dysfunction with multi- slice spiral CT angiography and to discuss its clinical application. Methods A total of32 hemodialysis patients with autologous arteriovenous fistula dysfunction were enrolled in this study. Multi-slice spiral CT scanning of dialysis passage was performed in all patients. Panoramic vascular imaging was obtained by using multi- planar reconstruction, curved- planar reconstruction, maximum intensity projection,volume rendering and vascular automatic bone- elimination techniques. The results were analyzed. Results The upper limb vessels on the diseased side and their relationship with the surrounding structures were clearly displayed in all patients, based on which the responsible vessels caused autogenous arteriovenous fistula dysfunction were determined. Different proper means of intervention were adopted for each patient. Surgical re- establishment of dialysis passage was carried out in 30 patients, and non- surgical treatment was employed in 2 patients in order to improve hemodialysis flow. Conclusion Panoramic vascular imaging with multi- slice spiral CT angiography can well display the responsible vessels caused autogenous arteriovenous fistula dysfunction, which is very helpful in guiding the clinical selection of the treatment.

关 键 词：动静脉瘘 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学] R692.5[医药卫生—临床医学]