先天性肾动静脉畸形的影像表现与栓塞治疗  

Imaging manifestations and efficacy of transcatheter embolization in congenital renal arteriovenous malformations

作　　者：朱聪辉[1] 林文集[1] 万建明[1] 陈斯经[1] 

机构地区：[1]福建医科大学附属泉州第一医院影像科,福建泉州362000

出　　处：《中国介入影像与治疗学》2015年第3期156-159,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价先天性肾动静脉畸形64层MSCT血管成像的影像表现与栓塞治疗效果。方法 6例肾动静脉畸形患者接受CTA及栓塞治疗,评价影像表现及栓塞治疗效果。结果 6例患者经肾动脉CTA及DSA检查确诊为静脉曲张型肾动静脉畸形;3例分流速度慢的患者采用单纯无水乙醇栓塞;3例分流速度快的患者中1例单独用无水乙醇,另2例采用无水乙醇＋聚乙烯醇颗粒（PVA）栓塞,均1次栓塞成功;复查增强CT并重建CTA显示畸形血管消失,肾实质梗死体积5%-22%。结论 CTA可作为静脉曲张型肾动静脉畸形栓塞前诊断及栓塞后随访的首选检查方法;无水乙醇栓塞治疗静脉曲张型肾动静脉畸形是一种安全有效、值得推荐的方法,与PVA配合使用可能减少无水乙醇的用量。Objective To evaluate the manifestations of 64-MSCT angiography（64-MSCTA）and therapeutic effect of transarterial embolization in renal arteriovenous malformations（rAVM）.Methods Six rAVM patients underwent CTA and transarterial embolization（TAE）.The imaging manifestations and therapeutic effect were evaluated.Results Six patients were diagnosed as cirsoids rAVM by CTA and DSA;3patients with slow arteriovenous shunt and 1patient with rapid shunt underwent TAE with absolute alcohol,and 2cases with rapid shunt combined with absolute alcohol＋polyvinyl alcohol（PVA）.All patients were embolized successfully one time.During the period of follow-up,there were no recurrence of hematuria and severe complications.CTA reexamination showed vascular malformation disappeared,and renal infarct volume ranged from 5%to 22%.Conclusion CTA should become the preferred method of examination of rAVM in preoperative diagnosis and postoperative follow-up.TAE with absolute alcohol for cirsoids rAVM is safe and effective,and combined with PVA may reduce the dosage of alcohol.

关 键 词：肾 动静脉畸形 栓塞 体层摄影术 X线计算机 血管造影术 

分 类 号：R692.16[医药卫生—泌尿科学] R816.2[医药卫生—外科学]