低辐射剂量无对比剂主动脉腔内隔绝术的可行性研究  

Feasibility study of endovascular aortic repair without contrast media at low radiation dose

作　　者：鲍云[1] 肖红艳[1] 陈立恒 李晓勇 祁明[1] BAO Yun;XIAO Hongyan;CHEN Liheng;LI Xiaoyong;QI Ming(Department of Cardiac Surgery,Wuhan Aisa Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院心外科导管室,湖北武汉430022

出　　处：《实用放射学杂志》2022年第7期1181-1183,1203,共4页Journal of Practical Radiology

摘　　要：目的探讨采用低辐射剂量无对比剂行主动脉腔内隔绝术(EVAR)的可行性及临床价值。方法根据辐射剂量以及对比剂使用情况分为2组:实验组(低辐射剂量无对比剂组)为35例B型急性主动脉综合征(AAS)患者。在数字减影血管造影(DSA)下仅采用透视模式并通过导管预置于左锁骨下动脉结合术前CT辅助定位无对比剂行EVAR术;对照组(常规辐射剂量使用对比剂组)为42例B型AAS患者,在DSA下采用透视结合照相摄影模式注射对比剂行主动脉造影再行EVAR。结果实验组EVAR手术成功率为100%;对照组的手术成功率为100%。实验组手术过程中患者总累积皮肤入射剂量平均为(41±1.37)mGy;对照组手术过程中患者总累积皮肤入射剂量平均为(469±25.8)mGy,差异有明显统计学意义(P=0.008)。实验组患者术后3个月复查发生内漏0例;对照组患者术后3个月复查发生内漏0例,差异无明显统计学意义(P>0.05)。结论采用低辐射剂量无对比剂技术对AAS患者行EVAR有效可行,并且可以大幅降低患者术中接受的辐射剂量;也可避免患者术后出现对比剂肾病的可能性。Objective To investigate the feasibility and clinical value of endovascular aortic repair(EVAR)with low radiation dose and no contrast media.Methods Patients with type B acute aortic syndrome(AAS)were divided into two groups according to the radiation dose and the use of contrast media.The experimental group(low radiation dose without contrast media)included 35 patients.In experimental group,patients received EVAR under digital subtraction angiography(DSA)in fluoroscopic mode with the application of preposition catheter in combination with CT-assisted localization without contrast media.The control group(conventional radiation dose with contrast media)was consisted of 42 B-type AAS patients admitted,who were injected with contrast media for aortography and then underwent EVAR under DSA.Results The success rate of EVAR was 100%in the experimental group,and 100%in the control group.The average cumulative skin dose during operation was(41±1.37)mGy for the experimental group,and(469±25.8)mGy for the control group.There was significant difference between two groups(P=0.008).There was no difference between experimental group and control group in post-operation intravascular leaking(P>0.05).Conclusion Low radiation dose,no contrast media technique is effective and feasible for EVAR in AAS patients,and it can significantly reduce the radiation dose during the operation and may avoid the possibility of postoperative contrast-induced nephropathy.

关 键 词：辐射剂量 对比剂 主动脉腔内隔绝术 

分 类 号：R814.2[医药卫生—影像医学与核医学] R543.1[医药卫生—放射医学]