经肱动脉选择性动脉DSA

随着DSA装置及小口径导管的普遍使用,近几年国外已较多地开展了经肱动脉DSA,取得了较满意的结果。目前国内尚无这方面的报告,为此本文收集12例经肱动脉选择性动脉DSA(另附2例穿刺失败者),就其有用性及安全性作一初步报告。     

下肢动脉DSA的临床应用

动脉数字减影(IADSA)目前多用于头部和胸腹部疾病的诊断及介入治疗,而在下肢动脉疾病的应用报道不多,现将我院DSA检查下肢动脉疾病的应用情况报道如下: 1 一般资料及方法 1.1 我院自1988年以来,共做下肢动脉法数字减影23例、71个系列,平均每例2.2个系列。其中男性20例,女性3例;平均年龄43岁。 1.2 方法:机器设备为日本岛津公司生产的DAR—     

支气管动脉DSA的质量控制

目的：总结138例肺癌的．186次支气管动脉DSA及化疗药物灌注。就对比剂的选择及注射量、流量的应用、减影方式、帧频、密度补偿等对图像质量的影响以及支气管动脉化疗灌注的流率与患的耐受程度进行分析，提出质量控制措施。方法：Seldinger导管法，导管插至支气管动脉开口处行DSA检查。遮挡双侧肺野，注射对比剂流率0.5—1．0ml／s，总量5—7m1，延时0．5—1．0s减影至10s。使用离子型对比剂119次；非离子型对比剂67次。脉冲方式减影182次，帧频6—10F／S；连续方式4次；6F／S和30F／S各1次；10F／S2次；常规对患进行呼吸训练。结果：图像质量优秀的57例，造成图像质量差主要是呼吸性伪影有137次，其中使用离子型对比剂108次，非离子型对比剂29次；心脏搏动性伪影22次，10F／S脉冲方式11次；6F／S脉冲方式和连续方式出现11次，强透过出现8次，注射流率超过0．5m1／s有17例逆流。结论：①支气管动脉DSA，使用非离子型对比剂图像优质率明显高于使用离子型对比剂，特别是能有效抑制呼吸性移动伪影，在支气管动脉造影中应首选；②支气管动脉造影不宜使用连续方式，应选择曝光脉宽较窄的脉冲方式，采集频率不能少于10F／S，这样有利于降低心脏搏动性伪影的出现；③正确遮挡肺野，低流率造影，也是提高图像府号的有效手段。     

下肢动脉的二氧化碳DSA造影

目的；探讨二氧化碳作下肢动脉造影的临床应用价值。材料与方法：３０例临床疑及下肢动脉病变者，经二氧化碳动脉数字减影血管造影（ＣＯ２－ＤＳＡ），再行泛影葡胺血管造影，将两者的诊断结果及影像质量进行对比。结果：下肢动脉ＣＯ２－ＤＳＡ的影像质量能达到诊断成碘剂结果一致，而影像质量以背景、血管边缘锐利度较碘剂差，结论：ＣＯ２作业上肢动脉造影的阴性造影剂是安全、有效、经济，对血管闭塞性病变有较大的潜力，但完全     

DSA在肝动脉造影中的评价

目的 分析肝动脉造影中影响DSA图像质量的相关因素，探讨DSA在肝动脉造影的价值及效果。     

子宫肌瘤动脉栓塞的DSA成像技术

子宫肌瘤是女性生殖系统最常见的良性肿瘤 ,传统治疗方法采用激素和手术 ,但常造成患者生理、心理的负面影响及治疗效果不佳。近年来 ,国内外尝试采用子宫动脉栓塞治疗子宫肌瘤。笔者就我院自 1999年以来 3 0例子宫肌瘤动脉栓塞的情况报告如下 ,着重探讨成像技术方面的问题。1　材料与方法3 0例患者 ,年龄 3 0～ 46岁 ,平均 3 6.5岁。主要临床表现为月经过多、继发性贫血和子宫肿块。全部病例均先行Ｂ超检查 ,提示为子宫粘膜下、肌间或浆膜下肿瘤。术前测定凝血时间、卵巢功能ＦＳＨ水平、血尿雌激素、尿孕二醇和血孕酮 ,以了解术前卵巢功能…     

下肢动脉硬化性闭塞症的DSA

目的：为给外科手术提供更多信息，对１０５例下肢动脉硬化性闭塞症患者作术前经动脉数字减影血管造影（ＩＡＤＳＡ）检查。材料和方法：经皮动脉穿刺插管后，用非离子型造影剂作腹主动脉下段至双胫腓动脉ＤＳＡ。结果：ＤＳＡ表现有：动脉狭窄、闭塞、血管壁溃疡，血管扭曲、延长，侧支形成。本组有８３例（７９．０％）双侧髂、股动脉呈对称性闭塞和／或狭窄。结论：下肢动脉硬化闭塞症好发于老年男性、常双侧发病，股髂动脉最易受累，ＩＡＤＳＡ能满足手术医生术前了解病变的需要，其对患者的创伤较小，可作为术前的常规检查方法     

子宫肌瘤DSA动脉造影152例分析

目的分析152例子宫肌瘤DSA血管造影的表现,总结子宫肌瘤血供特点和子宫动脉与主干的分叉角度,指导介入栓塞操作。方法子宫肌瘤行子宫动脉栓塞治疗的病例152例。术前均经B超、CT或MRI证实。肿瘤位于肌壁间74例,黏膜下32例,黏膜下和肌壁间共存46例。股动脉穿刺成功后行腹主动脉下端造影,其中91例进行旋转DSA快速造影。分别测量子宫动脉起始部分叉类型及其与主干的分叉角度,比较两侧子宫动脉供血的优势类型和各时相的表现特点。结果插管和DSA造影技术成功率100%。子宫动脉分叉成角小于30°者81例(53.3%),30°～60°者52例(34.2%),大于60°者19例(12.5%)。子宫动脉血管粗细和分支多少两侧不等者112例(73.7%),大量供血动脉包绕肌瘤者98例。实质期子宫肌瘤染色者124例(81.6%)。91例旋转DSA造影清楚显示子宫动脉开口达到89例(97.8%)。结论子宫肌瘤患者的子宫动脉大多明显增粗,两侧不对称常见。子宫肌瘤大多为富血供肿瘤,但是造影剂染色时间较晚。部分子宫动脉起始部与主干分叉角度较大,需在子宫动脉介入治疗时注意。     

Intra-arterial digital subtraction angiography of the carotid arteries

Summary A cross-over test in intra-arterial digital subtraction angiography (IADSA) of the carotid arteries was performed in 50 patients to evaluate image quality and side-effects with iohexol and metrizoate injected at concentrations of 100 mg I/ml by hand. The image quality was excellent or good in all cases. Although the severity and the frequency of side-effects were higher with metrizoate, both contrast media were suitable for IADSA at this low concentration. No complications were seen. It was assumed that the risk with IADSA was less than that of conventional precerebral angiography when performed semi-selectively and with small amounts of contrast media, as in this study.     

Intraarterial digital subtraction angiography in detection of hepatocellular carcinoma

To evaluate the usefulness of intraarterial digital subtraction angiography (IADSA) in hepatocellular carcinoma, IADSA was prospectively performed, combined with conventional film-screen angiography, in 40 patients in whom the tumor was histologically proven or highly suspected. Of the 16 main tumors less than 2 cm, IADSA detected 7 that were missed by film-screen angiography; 6 of these were less than 1 cm in size. With other diagnostic modalities including ultrasound; routine CT study, and CT after intraarterial Lipiodol injection, the detection rate of these tumors was low. IADSA's contribution is important in the detection of small hepatocellular carcinomas.     

动脉数字减影血管造影的临床应用

本文报告８０例动脉数字减影血管造影（ＩＡＤＳＡ）的初步经验，特别着重影像质量的评价。在本组病例，ＩＡＤＳＡ主要用于头颅、颈部、肺、腹部以及先天性心脏病的诊断。本组未发生重大并发症。ＩＡＤＳＡ的优点是：（１）影像质量好；（２）用于ＩＡＤＳＡ的剂量和浓度以及导管的直径均较用于常规血管造影的小得多，因此其副作用和并发症显著减少；（３）检查时间显著缩短，因此，ＩＡＤＳＡ对介入放射学治疗特别有用；（４）ＩＡＤＳＡ现已大部取代常规血管造影来诊断多种疾病。     

Peripheral vascular disease: prospective study of intraarterial digital subtraction angiography using a 9-inch intensifier

A prospective randomized study was undertaken to evaluate the role of intraarterial digital subtraction angiography (IADSA) in the study of peripheral vascular disease. Patients underwent either conventional film-based angiography alone, digital subtraction angiography (DSA) alone, or a combined study. With a 9-inch image intensifier, DSA alone resulted in cost savings of film and contrast material but required a significantly longer examination period than the other groups and an increased iodine dose per examination. When the images were analyzed by a radiologist and a vascular surgeon, the DSA studies provided less detail in the aortoiliac region than the other techniques but had advantages in demonstrating the runoff vessels. IADSA examination should not replace conventional arteriography in patients with peripheral vascular disease but has a useful complementary role.     

Intraarterial digital subtraction angiography with carbon dioxide: Superior detectability of arteriovenous shunting

Intraarterial digital subtraction angiography (IADSA) with carbon dioxide (CO₂) was performed on 41 patients with liver or renal diseases. CO₂ produced no hypersensitivity reactions, and the pain or feeling of warmth was relatively mild compared with iodinated contrast media. Although the image quality of the arterial or capillary phase was inferior to that with iodinated contrast media, the detectability of arteriovenous shunting was excellent. IADSA with CO₂ may become an effective method for detecting arteriovenous shunting which cannot be demonstrated with conventional angiography or DSA with iodinated contrast medium.     

蛛网膜下腔出血患者的MRA和DSA的对照研究

目的：研究ＭＲ血管造影（ＭＲＡ）在蛛网膜下腔出血（ＳＡＨ）患者病因诊断中的应用准确性和可靠性。材料和方法：回顾性分析３３例ＳＡＨ患者的ＭＲＡ资料，并与ＤＳＡ作了对比分析，ＭＲＡ采用三维时间流逝（３Ｄ－ＴＯＦ）法。结果：ＭＲＡ上显示了２６例血管病变中的２２例，包括１５个动脉瘤中的１３个，８例动静脉畸形中的６例和３例血管狭窄闭塞性病变。１个完全血栓形成的右颈内动脉瘤ＭＲＡ上未显示。但常规ＭＲＩ和ＭＲＡ原始图像上显示，ＭＲＡ结合ＭＲＩ和ＭＲＡ原始图像可以对９１％的患者做出正确诊断和评价，动脉瘤和周围血管的关系及ＡＶＭ的供血动脉和畸形结节能在ＭＲＡ上被准确评价。结论：作为一种非损伤性的血管成像方法，ＭＲＡ具有安全、可靠和方便的优点，可以做为常规用于ＳＡＨ患者的筛选检查。     

Use of the delayed mask for improved demonstration of aneurysms on intraarterial DSA.

PURPOSE: We retrospectively explored the use of the delayed mask technique for intraarterial digital subtraction angiography (IADSA) to demonstrate the anatomy of aneurysm necks. METHODS: The delayed mask technique was utilized in 22 patients who had craniotomies for aneurysms demonstrated at angiography. The operative notes were compared to the angiographic findings of both the traditionally masked IADSA and the delayed mask IADSA. In addition, an in vitro model was constructed to examine the relationship between the size of the aneurysm neck and the ability to indirectly define its anatomy by demonstrating the flow jet. RESULTS: In 12 of 22 cases, the delayed mask technique demonstrated a systolic jet that was not demonstrated by traditional subtraction techniques. In nine of 12 cases, the delayed mask technique gave more specific information regarding the size, location, and orientation of the aneurysm neck. CONCLUSION: The delayed mask technique can add important information regarding the anatomy of aneurysm without adding time or risk to the procedure.     

颅内动脉狭窄与闭塞的IADSA与CT诊断（附33例报告）

本文回顾性分析了３３例颅内动脉狭窄与闭塞性病变（包括烟雾病７例）的临床、ＣＴ及ＩＡＤＳＡ影象资料，认为：１、ＣＴ检查多表现为脑梗塞，并可据此粗略估计病变的动脉支，但有时脑梗塞的范围小于病变动脉的供血范围；２、ＩＡＤＳＡ可明确显示动脉狭窄与闭塞状况、毛细血管期染色及侧支循环；烟雾病有典型表现，可确诊；３、提出了改进ＩＡＤＳＡ检查本病的设想。     

Time-resolved two-dimensional thick-slice magnetic resonance digital subtraction angiography in assessing brain tumors

The aim of this study was to evaluate clinical applicability of two-dimensional (2D) thick-slice, contrast-enhanced magnetic resonance digital subtraction angiography (MRDSA) with high temporal resolution in diagnosis of brain tumors. Forty-four patients with brain tumors including, 15 meningiomas, 8 gliomas, 6 metastatic tumors, 4 neuromas, and 2 hemangioblastomas, were studied with 2D MRDSA with frame rate approximately 1 s. Images were continuously obtained following the initiation of bolus injection of gadolinium chelates for 40 s and subtraction images were generated in a workstation. We evaluated visualization of normal cranial vessels on MRDSA and compared MRDSA and intra-arterial digital subtraction angiography (IADSA) with regard to hemodynamic information. Large cerebral arteries, all venous sinuses, and most tributaries were clearly visualized. A stain was present in hypervascular tumors including all 15 meningiomas and 2 hemangioblastomas on MRDSA. Presence of a stain demonstrated on MRDSA and that on IADSA coincided in 16 of 20 cases (Spearman rank correlation value was 0.85). The location, shape, and phase of the stain on MRDSA were similar to those on IADSA. Two-dimensional MRDSA with high temporal resolution has a unique ability to demonstrate cerebral hemodynamics, such as IADSA, and can play an important role in assessing brain tumors. Received: 8 October 1999; Revised: 30 November 1999; Accepted: 7 December 1999     

The non-invasive detection of intracranial aneurysms: are neuroradiologists any better than other observers?

Can non-neuroradiologists detect intracranial aneurysms as well as neuroradiologists, using CT and MR angiography? Sixty patients undergoing intra-arterial digital subtraction angiography (IADSA) to detect aneurysms also underwent computed tomographic angiography (CTA) and time-of-flight magnetic resonance angiography (MRA). Consensus review of IADSA by two neuroradiologists was the reference standard. Two neuroradiologists, a neurosurgeon, a neuroradiographer and a general radiologist blinded to IADSA, plain CT and clinical data, independently reviewed hard-copy base and reconstructed maximum intensity projection images of the CTA and MRA studies. Thirty patients had a total of 63 aneurysms, 71.4% were 相似文献