脑膜瘤数字减影血管造影的诊断评价

随着诊断器材和技术的进步,脑膜瘤发病率和检出率逐年增高。本研究通过对22例脑膜瘤患者诊断,评价DSA在脑膜瘤诊断中的价值。1材料和方法1.1一般资料22例患者,男9例,女13例,年龄22～68岁。主要症状为头痛、视力障碍、癫痫发作等。所有病例均行双侧颈总及颈内、外动脉造影。造影     

脑膜瘤的数字减影血管造影和术前栓塞

脑膜瘤患者行数字减影血管造影及术前栓塞已成为脑膜瘤诊治的重要手段之一。对于颅底部位较大的脑膜瘤和累及静脉窦的脑膜瘤，多行DSA检查。其血管造影成像特点是呈放射状影像，其供血动脉多为颅内外的脑膜支。术前栓塞可使脑膜瘤变小、变软、血供减少，因此，可使手术时间缩短，术中出血减少，减少由于牵拉和操作脑组织而引起的对脑组织的损伤。应用的栓塞剂多为多聚乙醇(polyvinyl alcohol，PVA)颗粒，直径多为255-350μm，目的是栓塞肿瘤的血管床而非仅仅栓塞肿瘤的供血动脉。只要避开颅内外危险吻合和颅内正常分支，脑膜瘤的术前栓塞是安全有效的。     

烟雾病数字减影血管造影的诊断价值

目的评价数字减影血管造影(DSA)对烟雾病的诊断价值。材料与方法对13例烟雾病患者行DSA检查及回顾性分析。结果13例烟雾病DSA表现为不同程度颈内动脉分叉处血管狭窄或闭塞,侧支循环形成呈烟雾状。结论DSA可清晰地显示烟雾病血管狭窄程度或闭塞的部位及侧支循环情况,为临床治疗提供直接的影像学资料。     

消化道出血的数字减影血管造影诊断和栓塞治疗

消化道出血是临床常见病和多发病。随着临床医学和医学影像的发展 ,消化道出血的常用诊断方法有 :纤维电子内镜、全消化道造影和小肠气钡造影、核素显像、吞线试验等[1,2 ] 。上述方法虽各有特色 ,但选择性数字减影血管造影不仅可明确病变的部位和性质 ,而且可对病变血管行栓塞治疗[1,3,4 ] 。我们对 9例难治性消化道出血行ＤＳＡ诊断 ,并对其中 7例进行了栓塞治疗 ,现就其疗效作一分析。材料和方法本院消化科和普外科 1995年 11月至 1999年1月收治各种难治性消化道出血 9例 ,男 8例 ,女 1例 ,年龄 2 5～ 71岁 ,平均 4 2岁。选用美国ＯＥＣ …     

数字减影血管造影诊断小儿大动脉炎

目的：用数字减影血管造影（DSA）显示小儿大动脉炎。方法：用DSA对12例小儿多发性大动脉炎进行检查。结果：胸主动脉及弓部狭窄2例（17％），均同时合并左颈总及左锁骨下动脉狭窄。腹主动脉狭窄10例（83％）其中合并肾动脉狭窄9例。髂总动脉狭窄1例，骼内动脉狭窄1例，常外动脉狭窄1例，馆外动脉完全闭塞1例。结论；与常规血管造影术比较。DSA具有造影剂用量少，病变显示忧的特点。     

Moyamoya病数字减影血管造影的诊断价值

目的评价数字减影血管造影(DSA)对Moyamoya病分期诊断的价值。方法对31例患者的DSA检查进行了回顾性分析。结果31例DSA显示不同程度的颈内动脉分叉处血管狭窄或闭塞以及侧支循环;并根据Suzuki分期对31例患者57个大脑半球病变进行了分期：属于Ⅰ期病变者有4个大脑半球,Ⅱ期10个,Ⅲ期17个,Ⅳ期12个,Ⅴ期6个和Ⅵ期8个。结论DSA可清晰显示Moyramoya病血管狭窄的程度、闭塞部位及侧支循环的情况,并作出分期,从而可指导临床及早选择手术治疗。     

数字减影血管造影临床应用的初步体会

本文介绍了51例数字减影血管造影的应用情况。介绍静脉法及动脉法数字减影血管造影方法,并提出静脉法数字减影血管造影创伤小、检查快速、适合于老年及幼年患者,动脉法数字减影血管造影则使图像质量明显提高,优于普通血管造影,并可同时进行介入性治疗。对于可能出现的并发症本文亦一一作了介绍。     

三维数字减影血管造影影像在颈动脉狭窄血管内治疗中的价值

目的 评价三维数字减影血管造影(3D DSA)在颈动脉狭窄血管内治疗中的价值。方法 对138例缺血性脑血管病颈动脉的3D DSA与二维(2D)DSA图像进行比较，分析颈动脉的形状、狭窄的显示、血管内治疗的必要性、血管内治疗的工作角度及支架的选择。结果 与2D DSA相比，3D DSA能更清晰显示颈动脉狭窄的形状及程度，能提供最佳血管内治疗的工作角度，使用3D DSA能正确决策支架的选择。结论 3D DSA在颈动脉狭窄血管内治疗中具有重要的价值，能提供许多2D DSA不能提供的有价值信息，对常规DSA是一种有益的补充。     

甲状腺疾病数字减影血管造影分析

目的 分析各种甲状腺疾病血管造影表现特点,为临床治疗提供资料。材料与方法 行甲状腺数字减影血管造影（DSA）共56例,其中甲状腺机能亢进37例,甲状腺腺瘤13例,结节性甲状腺肿5例,胸骨后甲状腺肿1例,静脉法DSA37例,动脉法DSA9例,结果 56例病变显示清楚,其中36例经手术切除,符合率为98%,无1例发生并发症。结论 DSA能显示甲状腺病变供血特点,有助于甲状腺疾病的诊断与鉴别诊断。指导甲状腺机能亢进的介入性栓塞治疗。     

Stepped digital angiography with dynamic subtraction: a new diagnostic approach to peripheral angiography

On the basis of our first experiences, a purchasable angiography system for peripheral angiography with dynamic subtraction and stepping (DPSA) has been developed. This study reports on the optimization of this technique and the first clinical results in comparison with conventional screen-film angiography and digital subtraction angiography (DSA) in single steps. For each method, 25 angiograms were interpreted to compare the image quality, the radiation exposure, the contrast medium and the film consumption as well as the examination time. Image quality proved to be comparable in DPSA and DSA in single steps. Both techniques showed better results than conventional angiography, especially in the region of the knee and lower leg. Using DPSA radiation exposure dropped by a factor of 2 compared with conventional angiography and by a factor of 6 compared with DSA in single steps. Consumption of contrast medium can also be reduced in comparison with the other two methods. Film consumption is incomparably higher in conventional screen-film angiography. With DPSA the examination time can be reduced by half on average compared with the other two methods. DPSA may come to be the standard in peripheral angiography. Correspondence to: U. Fink     

Upper-extremity venography using digital subtraction angiography

Venography to evaluate the patency of upper-extremity veins was performed with digital subtraction angiography (DSA) and conventional angiography. Venous thrombosis was easily diagnosed, and the innominate veins and superior vena cava were more easily visualized using DSA. Iodine concentration for DSA was one-third that of conventional venography, and the examination time was reduced by 50% using DSA. Patient comfort and acceptance were greater with DSA. DSA is a superior technique for upper-extremity vein evaluation in cooperative patients.     

64层螺旋CT与数字减影血管造影对颅内动脉瘤诊断的比较

目的 通过64层螺旋CT的CT血管造影(CTA)及CT数字减影血管造影(CTDSA)技术与数字减影血管造影(DSA)的比较研究,评价64层螺旋CT在颅内动脉瘤诊断中的临床应用价值。方法 26例临床怀疑颅内动脉瘤的患者实施64层CT和DSA检查,对64层CT图像进行了CTA和DSCTA两种方式的后处理。CTA后处理技术包括容积再现(VR),最大密度投影(MIP)和多平面重建(MPR),在CTA图像基础上用增强数据逐层减去平扫数据,自动去除骨与脑组织,获得CTDSA影像。比较3种技术(DSA、CTA和CTDSA)的特征。结果 26例可疑患者中,DSA和CTDSA发现31个动脉瘤,CTA发现29个动脉瘤。CTA漏掉的2个动脉瘤,直径小于3mm。结论 CTDSA是检查颅内动脉瘤的高度敏感的影像学方法,具有与DSA相当的价值。     

三维DSA容积重建在颅内小动脉瘤中的诊断价值

目的：评价三维数字减影血管造影（DSA）容积重建在颅内小动脉瘤的诊断价值。方法对129例可疑颅内动脉瘤患者在行弹簧圈栓塞前进行二维DSA和三维容积重建-数字减影血管造影（VR-DSA）检查。结果三维VR-DSA显示105例患者有123枚动脉瘤，24例无动脉瘤。3例患者检测到3枚动脉瘤；12例患者同时检测到2枚动脉瘤；90例患者检测到1枚动脉瘤。所有的动脉瘤的形态在三维VR-DSA上均可清晰显示。二维DSA显示98例患者有110枚动脉瘤，31例无动脉瘤。1例患者检测到3枚动脉瘤；10例患者同时检测到2枚动脉瘤；87例患者检测到1枚动脉瘤。仅65例患者的动脉瘤的形态在二维DSA上可清晰显示。三维VR-DSA发现13例额外动脉瘤，位于颈内动脉（10例，77％），位于前交通动脉（3例，33％）。大脑中动脉与椎基底动脉未发现额外动脉瘤。结论三维容积DSA不仅能清晰显示动脉瘤的大小及形态，而且能检测出二维DSA未检出的动脉瘤，特别是微小动脉瘤。     

Intravenous digital subtraction angiography in patients with Aorto-arteritis (Takayasu's)

Aorto-arteritis is one of the commonest vascular diseases in China as well as in Japan and other parts of Asia. The results of digital subtraction angiography (DSA) in 50 patients with aortoarteritis are reported, and the merits and demerits of intravenous (IV) DSA in the diagnosis of this entity are evaluated. Among the 51 studies performed on 50 patients, IV DSA was used in 48, intraarterial (IA) DSA in 3, and good-to-excellent visualization was obtained in 96% of patients. Aorto-arteritis of varying severity and involving the thoraco-abdominal aorta, the iliac arteries, and other major branches was clearly demonstrated by IV DSA. IV DSA, as compared to our previous experience with conventional arteriography in this entity, may be substituted for conventional arteriography in most patients. A large dose of contrast media needed for a complete study is a major deficiency of IV DSA, and it also has limitations for showing the intrarenal arterial branches.     

CTA减影在颅内动脉瘤诊断中的应用价值

目的:评价CT血管造影(CTA)减影术在颅内动脉瘤诊断中的应用价值。方法:采用CT血管造影检查拟诊颅内动脉瘤33例,图像分别运用A(经减影后)及B(常规)进行两次三维(3D)成像:最大密度投影(MIP)、表面遮盖成像(SSD)、容积重建(VR)。以手术或随访为标准评价两种检查结果;由两位有经验的神经外科医生、两位放射科医生双盲法评价图像质量。结果:A法检出动脉瘤36个(三例患者为多发动脉瘤),显示瘤体、瘤颈、载瘤动脉和周围血管的关系清晰、确切。B法检出动脉瘤31个,漏检1个大脑前动脉瘤2、个前交通动脉瘤、2个颈内动脉瘤。A法的检出率为100%,B法的检出率为86%。两者检出率经χ2检验有统计学意义。结论:CTA减影3D成像对颅内动脉瘤的诊断优于常规3D。     

旋转式三维数字减影血管造影在脑动脉瘤临床诊断和治疗中的应用价值

目的：探讨旋转式三维数字减影血管造影在脑动脉瘤诊断和治疗中的应用价值，提高诊断水平，增强治疗效果。方法：回顾性分析了213例脑动脉瘤患者的二维、三维数字减影脑血管造影的影像学资料，并对其结果进行了对比分析。结果：213例患者中共检出222枚脑动脉瘤，其中囊性动脉瘤197枚，梭形动脉瘤16枚，夹层动脉瘤9枚；在222枚脑动脉瘤中，小型动脉瘤105枚，中型动脉瘤89枚，大型动脉瘤22枚，巨大型动脉瘤6枚。常规DSA清楚显示的有205枚，17枚显示可疑由三维数字减影脑血管造影进一步证实；对138例脑动脉瘤患者进行手术开颅银夹夹闭治疗，19例进行介入性金属微弹簧圈栓塞治疗。结论：旋转式三维脑血管造影可有效提高脑动脉瘤的诊断准确性和多种治疗方法的安全十牛及疗效。     

Clinical application of hybrid subtraction digital angiography: Preliminary results

The clinical application of hybrid subtraction in digital fluoroscopy of the vasculature is reported in our first 30 patients studied. Hybrid subtraction combines the advantages of temporal and dual energy subtraction techniques to achieve simultaneous elimination of overlying bone, soft tissue, and motion induced artifacts. Hybrid subtraction improved the subjective appearance of an image in 19 of 30 (63%) studies but additional diagnostic information was only revealed in 11 of 30 (37%) patients. This study was supported in part by the General Electric Company Medical Systems Division and the National Heart, Lung, and Blood Institute (Contract #HV-02922)