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硬脊膜动静脉瘘的影像学特点及治疗 总被引:7,自引:0,他引:7
目的:对24例硬脊膜动静脉瘘(SDAVF)的影像学特点及治疗进行讨论。材料与方法:1983年1月至1996年1月共收治硬脊膜动静脉瘘24例,全部患者均表现为进行性脊髓损害。除1例(术中证实)外,均经选择性脊髓血管造影证实。9例病人治疗前后行MRI检查。在24例病人中,单纯栓塞5例,单纯手术14例,栓塞+手术4例,未治1例。结果:23例治疗者中,痊愈7例,改善12例,无变化3例,加重1例。结论:SDAVF是脊髓血管畸形中的一个类型,影像学特点为硬脊膜动脉与脊髓表面静脉相通,引流静脉几乎贯穿脊髓全长。治疗的关键是栓塞或夹闭瘘口。 相似文献
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部分性脾栓塞在肝癌介入治疗中的应用(附30例报告) 总被引:1,自引:0,他引:1
目的:探讨部分性脾栓塞(PSE)在肝癌介入治疗中的意义和方法。材料与方法:采用肝动脉化疗栓塞术(THAE)和PSE并用的方法治疗30例合并肝硬化、门脉高压和脾功能亢进的肝癌患者。将PSE的栓塞材料明胶海绵限制在160粒以内以防止过量栓塞。结果:27例脾栓塞面积在50%以上;25例脾功能亢进缓解;26例食管静脉曲张包括6例有消化道出血者,5例于PSE后1年之内未再发生出血;未发生脾脓肿等严重并发症。3例脾栓塞面积在50%以下的患者中2例脾功能亢进未缓解。结论:PSE与THAE并用是治疗肝癌合并肝硬化、门脉高压和脾功能亢进的安全、有效的方法。栓塞剂定量的方法有助于避免脾的过量栓塞,减少并发症。 相似文献
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部分性脾栓塞术的质量控制 总被引:76,自引:2,他引:76
目的探寻术中较准确地控制脾栓塞程度的方法。方法回顾性地分析90例部分性脾栓塞(partialsplenicembolization,PSE)术患者栓塞前、后的脾动脉造影表现,总结出大小为1mm×1mm×1mm明胶海绵颗粒数(G)、内径约1mm脾内动脉支数(A)与栓塞程度(Ee)的关系。以此为依据对24例脾亢患者进行前瞻性研究,栓塞(E)前先根据Ee预期、A值确定明胶海绵用量,行PSE术后,比较Ee实际与Ee预期的偏差。结果G、A与E(Ee×100)的关系为G=(E-11.45)A/50.79。运用本公式可确定栓塞剂用量,从而控制Ee,95%偏差范围将控制在-5.8%~6.8%。结论根据预期栓塞程度与脾内动脉分支数确定明胶海绵颗粒用量,从而控制栓塞程度是一种简便可靠的定量脾栓塞法 相似文献
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明胶海绵加真丝线段栓塞支气管动脉治疗大咯血 总被引:9,自引:0,他引:9
目的探讨用明胶海绵(GS)加真丝线段(ST)进行支气管动脉栓塞治疗大咯血的效果。材料与方法31例大咯血病人均行急诊支气管动脉栓塞(BAE),其中,单纯性GS栓塞10例,GS加ST栓塞21例。结果单纯性GS栓塞组,9例立即止血,1例3天后止血。10例中4例1年内复发,在GS加ST栓塞组,21例均立即止血,有2例1年内复发。结论GS加ST栓塞支气管动脉治疗大咯血效果好且复发率低。 相似文献
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电影式DSA对介入治疗大咯血的动态观察 总被引:1,自引:1,他引:0
肺部病变并急性大咯血是临床危及生命的常见急症,行支气管动脉栓塞术(BAE)已有20多年的历史[1~4],多数病例能取代外科手术治疗。本文采用数字成像系统、电影式DSA动态观察出血表现,定位并在其监控下行支气管动脉栓塞治疗42例急性大咯血,现报告如下。... 相似文献
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肝动脉化疗栓塞及注射无水乙醇,^32P—玻璃微球治疗原发性?… 总被引:3,自引:0,他引:3
目的 评价肝动脉化疗栓塞(TAE)结合B超引导下注射无水乙醇(PEI)、^32P-玻璃微球(^32P-GMS)治疗原发性肝癌的临床价值。方法 83例中、晚期肝癌分为2组,43例综合应用TAE+PEI+^32P-GMS治疗,40例单纯应用TAE治疗。结果 综合治疗组手术切除14例(33%),有9例肿瘤组织完全坏死,5例有残存的肿瘤细胞,单纯TAE组手术切除4例(10%),肿块及周边有肿瘤细胞,血清A 相似文献
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目的 :探讨骨和肌肉组织肿瘤的超选择动脉栓塞术的临床价值。方法 :运用Seldinger技术 ,对 18例骨和肌肉组织肿瘤进行造影 ,灌注和超选择动脉栓塞术 ,栓塞材料运用明胶海绵粒加抗癌药浸泡。结果 :18例骨和肌肉组织肿瘤中14例进行了栓塞 ,其中彻底栓塞者 8例 ,部分栓塞 6例 ;栓后肿块明显缩小 ,有 10例栓后肿瘤切除术 ,术中出血减少 ,肿瘤切除容易、彻底 ;4例孤息性栓塞 ,疼痛减轻 ,生存质量改善。结论 :骨和肌肉组织肿瘤的超选择动脉栓塞术 ,能使肿块缩小 ,提高生存质量 ;特别是术前栓塞能减少术中出血 ,以利肿瘤切除 相似文献
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Brechtel K Bail D Schwentner C Heller S Schmehl J Goebel N Scheule AM Claussen CD Kalender G 《Journal of vascular and interventional radiology : JVIR》2011,22(4):563-568
The authors report two cases of stent-assisted embolization (SAE) in the aorta. In one case, SAE was performed for treatment of a pseudoaneurysm; the procedure consisted of stent placement and embolization with an AMPLATZER Vascular Plug and detachable coils through the stent struts. In the second case, SAE was performed to stop acute bleeding from an aortoureteral fistula. Before SAE in this case, the aortic bifurcation was reconstructed with self-expandable and balloon-expandable stents. SAE was technically successful in both cases. SAE for aortic pathologic processes may be useful in selected cases as an alternative to surgery or endovascular stent-graft therapy. 相似文献
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目的:探讨介入治疗在骨组织肿瘤临床治疗中的价值。方法:31例骨组织肿瘤患者均接受动脉化疗和/或栓塞术,部分患者于栓塞后2~15d行外科手术;未行手术患者继续采用动脉化疗和栓塞治疗,同时加放疗、静脉化疗等综合治疗,观察临床效果。结果:21例进行了肿瘤完全切除或扩大根治术,其中6例股骨肉瘤患者局部刮除并行人工膝关节置换术;10例未进行手术治疗,加行放疗、化疗等综合治疗。手术病例术中出血量明显减少,平均术中失血为1170ml,显示肿瘤缩小、软化、组织坏死。其中统计的20例原发恶性肿瘤患者1年生存率为90%,2年生存率为75%,9例患者5年生存率44.4%。结论:介入治疗是骨组织肿瘤的有效治疗方法,术前栓塞治疗可大大减少术中出血,动脉化疗栓塞作为综合治疗的重要手段能有效延长患者生存期和提高生存质量。 相似文献
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目的 评估骶、髂骨肿瘤术前经导管超选择性动脉栓塞的价值和作用.方法对15 例骶、髂骨肿瘤用明胶海绵颗粒行超选择性动脉栓塞,栓塞后1~3 d行手术切除.疾病包括:骨巨细胞瘤5 例、动脉瘤样骨囊肿2例、转移瘤2 例、软骨肉瘤4例、脊索瘤3例.结果本组15 例栓塞后造影均显示肿瘤染色范围均较术前减少80 %以上.术中失血500~2600 ml 之间,平均为1100 ml .所有肿瘤均被顺利切除.结论 骶、髂骨肿瘤手术治疗前超选择性动脉栓塞能安全有效地减少术中出血, 提高肿瘤手术治疗效果并降低手术的风险. 相似文献
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目的研究脊椎原发性骨肿瘤术前化疗及选择性动脉栓塞的安全性、疗效评价标准及临床价值。方法对术前采用化疗及选择性动脉栓塞且术后经病理证实的16例资料完整的椎体肿瘤进行回顾性分析。采用Seldinger技术,将导管超选择性地插入所需栓塞的肿瘤供血动脉,进行化疗,再以明胶海绵颗粒为栓塞材料进行选择性动脉栓塞。结果化疗、栓塞后肿瘤供血动脉大部分阻断,肿瘤染色较栓塞前减少>75%,术中出血量为500~2000ml,平均为810ml,手术切除顺利;术后标本病检肿瘤细胞坏死率为91%~95%;疼痛症状缓解率为95%。本组均未发生严重并发症。结论脊椎肿瘤术前行化疗及选择性动脉栓塞,是一种操作简便,安全可靠的有效方法。 相似文献
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《Journal of vascular and interventional radiology : JVIR》2022,33(5):505-509
Splenic artery embolization (SAE) plays a critical role in the treatment of high-grade splenic injury not requiring emergent laparotomy. SAE preserves splenic tissue, and growing evidence demonstrates preserved short-term splenic immune function after SAE. However, long-term function is less studied. Patients who underwent SAE for blunt abdominal trauma over a 10-year period were contacted for long-term follow-up. Sixteen participants (sex: women, 10, and men, 6; age: median, 34 years, and range, 18–67 years) were followed up at a median of 7.7 years (range, 4.7–12.8 years) after embolization. Splenic lacerations were of American Association for the Surgery of Trauma grades III to V, and 14 procedures involved proximal embolization. All individuals had measurable levels of IgM memory B cells (median, 14.30 as %B cells), splenic tissue present on ultrasound (median, 122 mL), and no history of severe infection since SAE. In conclusion, this study quantitatively demonstrated that long-term immune function remains after SAE for blunt abdominal trauma based on the IgM memory B cell levels. 相似文献
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Roushan Jha Raju Sharma Shishir Rastogi Shah Alam Khan Arvind Jayaswal Shivanand Gamanagatti 《World journal of radiology》2016,8(4):378-389
AIM:To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss,intraoperative blood transfusion volume and surgical time.METHODS:Thirty-three patients underwent preoperative embolization of primary tumors of extremities,hip or vertebrae before resection and stabilization.The primary osseous tumors included giant cell tumors,aneurysmal bone cyst,osteoblastoma,chondroblastoma and chondrosarcoma.Twenty-six patients were included for the statistical analysis(embolization group)as they were operated within 0-48 h within preoperative embolization.A control group(non-embolization group,n = 28)with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison.RESULTS:The mean intraoperative blood loss was 1300 mL(250-2900 mL),the mean intraoperative blood transfusion was 700 m L(0-1400 m L)and the mean surgical time was 221 ± 76.7 min for embolization group(group Ⅰ,n = 26).Non-embolization group(group Ⅱ,n = 28),the mean intraoperative blood loss was 1800 m L(800-6000 m L),the mean intraoperative blood transfusion was 1400 mL(700-8400 mL)and the meansurgical time was 250 ± 69.7 min.On comparison,statistically significant(P < 0.001)difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion.There was no statistical difference between the two groups for the surgical time.No patients developed any angiography or embolization related complications.CONCLUSION:Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume. 相似文献
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Giuseppe Rossi Eugenio Rimondi Tommaso Bartalena Antonio Gerardi Marco Alberghini Eric Lodwijk Staals Costantino Errani Giuseppe Bianchi Angelo Toscano Mario Mercuri Daniel Vanel 《Skeletal radiology》2010,39(2):161-167
Background
Aneurysmal bone cyst (ABC) is a lytic benign bone lesion representing about 1% of all primary bone tumors. The lesion causes pain and swelling, which are generally present for less than 3 months.Methods
From April 2003 to April 2008 36 patients affected by aneurysmal bone cysts were treated by selective arterial embolization with N-2-butyl cyanoacrylate. The study population comprised 20 male and 16 female patients with an age range of 3.3–60.8 years. Nine lesions were localized in the appendicular skeleton (1 in the upper and 8 in the lower limb), 4 in the thoracic cage (1 rib lesion and 3 scapular lesions), 17 in the pelvis and 6 in the spine (1 thoracic and 5 sacral localizations).Results
A total of 55 embolizations were performed: in 22 cases (61%) only one embolization was needed, whilst two embolizations were necessary in 9 cases (25%) and 3 in the remaining 5 patients (14%). The treatment was effective in 32 patients (94% ): follow-up was 0.9–5 years. In one patient, previously surgically treated, only the cyanoacrylate embolization turned out to be useful for healing the lesion. Another 7 patients underwent surgery during the study period. In the 55 procedures we performed we had 3 complications (5%): 2 cases of skin necrosis and 1 of transient paresis.Conclusions
Arterial embolization with cyanoacrylate may be the treatment of choice for aneurysmal bone cysts. Embolization is a less invasive, lower cost, simpler procedure than surgery and is easily repeatable. 相似文献19.
Nitta N Ohta S Tanaka T Takazakura R Nagatani Y Kono N Sonoda A Seko A Furukawa A Takahashi M Murata K Tabata Y 《European journal of radiology》2008,67(3):536-540
PURPOSE: The purpose of this study is to evaluate the embolization effects of gelatin microspheres (GMSs) when used as an embolic material for transcatheter arterial embolization (TAE) for several organs. MATERIALS AND METHODS: We prepared GMSs that dissolves in 5 days in extravasuclar tissue. GMSs were used in five cases in total, four cases with multiple liver tumors and one case with a pelvic bone tumor. RESULTS: In all five cases, it was possible to treat the targeted tumors by TAE with GMSs. In the contrast-enhanced CT performed 2-4 weeks later, the embolized tumors did not show an enhancement effect. Passage of GMSs in the microcatheter was excellent. CONCLUSION: GMSs showed sufficient potential to be used as an embolic material. 相似文献
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选择性椎体供血动脉栓塞的动物实验研究 总被引:2,自引:0,他引:2
目的 通过对实验犬进行选择性椎体供血动脉栓塞的研究,旨在建立椎体急性缺血模型以及探讨影响栓塞结果的因素,为临床更好地实施脊柱肿瘤术前动脉栓塞提供理论依据。方法 用明胶海绵对12只实验犬分别行单节段和多节段选择性腰动脉造影和栓塞,栓塞后1-7d内观察后肢功能情况、靶节段椎体、脊髓MRI表现和病理改变。结果 栓塞单节段(双侧)或多节段腰动脉者均引起椎体不同程度的缺血、坏死改变。栓塞单根腰动脉者,不管靶动脉是否发出根髓动脉其靶椎体未见明显变化和未发生瘫痪;栓塞多节段腰动脉者有1只犬发生不全。在栓塞单节段以上腰动脉的脊柱节段水平可背部肌肉发生不同程度的缺血坏死表现。结论 (1)选择性动脉栓塞可用于椎体急性缺血模型的制作,为椎体缺血性病变的实验性诊断和治疗研究提供可能。(2)单节段动脉栓塞难于使整个椎体缺血坏死。(3)多节段动脉栓塞时有可能引起并发症,特别是栓塞范围内存在根髓动脉时。(4)在作选择性脊柱动脉检塞时,必要时应行保护性栓塞。 相似文献