不明原因小肠出血数字减影血管造影价值

目的探讨DSA血管造影对不明原因小肠出血的诊断价值。方法25例小肠出血患者,均经Seldinger法行肠系膜上动脉插管造影。结果显示出血直接征象11例,出血间接征象12例,其中5例同时具有直接征象和间接征象。直接诊断出血18例,阳性率72%。病变性质为:肿瘤性病变10例,其中平滑肌瘤6例,平滑肌肉瘤2例,间质瘤1例,小肠癌1例。梅克尔憩室4例,血管畸形3例,炎症1例。阳性病例与手术病理诊断的符合率为75%,定位诊断符合率100%。结论DSA血管造影对不明原因的小肠出血的定位、定性诊断有肯定的价值。     

二氧化碳数字减影血管造影技术

使用离子型碘造影剂血管造影的各种副作用 (包括过敏、肾毒性、发热、疼痛等 )的发生率达 12 .6 6 % ,使用非离子型造影剂副反应率仍达 3.13% [1 ]。且其价格昂贵 ,国内病人使用受到限制。将 CO2 气体注入血管行数字减影血管造影 (CO2 - DSA)可用于除心、脑以外的各种病变的诊断并介导介入放射操作[2 ,3] 。笔者通过动物实验证实国产医用纯 CO2 血管造影的安全性后 ,将其应用于临床。1　资料和方法1.1　临床材料 :本组 85例病人行 CO2 - DSA,包括肝动脉造影 6 5例 ,脾动脉造影 4例 ,肾动脉造影 4例 ,肠系膜上动脉造影 2例 ,直接门静脉…     

二氧化碳数字减影血管造影在直接门脉造影中的应用

随着门脉穿刺插管技术的进步,使其在临床上的应用越来越广泛。直接门脉穿刺造影是显示门脉情况、了解门脉血流动力学和成分最客观、最直接的方法。临床上可用于诊断门脉本身的病变如门脉闭塞、门脉栓子及栓子活检以确定栓子性质,还可用于采集门脉血标本以测定胰岛素或胃泌素浓度,对胰岛素瘤或胃泌素瘤作定性诊断。在治疗上可用于进行门脉栓塞术、溶栓术、门脉内化疗灌注或灌注营养素和胰源性激素以营养肝细胞以及行经颈静脉肝内门体分流术（ＴＩＰＳ）等［１］。虽然应用常规碘造影剂造影可以取得较为满意的图像,但各种反应的发生率为３…     

间接门静脉数字减影造影对肝癌血供的研究

目的 研究肝癌有无门脉供血。材料与方法 １１６例经临床及影像学资料证实的肝癌,采用经腹腔动脉或肠系膜上动脉行间接门静脉ＤＳＡ方法,观察肝癌有无门脉供血。结果 １１６例肝癌中１０３例仅有肝动脉而无门静脉供血,只有１３例有肝动脉和门静脉双重供血（占１１．２％）。门脉供血表现为环状或少量染色。９７例原发性肝癌和１９例转移性肝癌有门脉供血者分别有１０例（占１０．３％）和３例（占１５．８％）,两者无显著性差     

数字减影在脑血管造影中的临床应用

目的 评价DSA在脑血管造影中的应用及其临床价值。方法 回顾分析采用Seldinger技术脑血管造影64例，就其影像学表现并结合文献加以总结。结果 64例中，脑血管造影未见异常26例，占40．63％；动脉瘤30例，占46．88％；动静脉畸形7例，占10．93％；颈内动脉海绵窦瘘1例，占1．56％。结论 数字减影脑血管造影其定位、定性准确率高、图像清晰，在神经介入诊断和治疗中具有重要的临床价值。     

数字减影脑血管造影技术

数字减影血管造影术（digital subtraction angiography,简称DSA）是一种较先进的非光学X线减影技术，它通过将数字信息经计算机处理和运算后得减影（纯血管）图像，目前DSA的应用范围在不断扩大，近一年来，我科已进行头颈，胸，腹和四肢等部位214例次的DSA检查，本文就其中46人68次颅内血管DSA的有关技术方面作一介绍。     

常规神经放射诊断中运用动脉数字减影血管造影的经验

数字减影血管造影术随着诊断仪器的改进,其诊断价值不断提高,同样,对神经放射学诊断也显示其重要性。本法有省时、价廉、对患者负担小的优点。     

肝海绵状血管瘤CO2—DSA与常规DSA的比较研究

目的：评价二氧化碳数字减影血管造影（CO2－DSA）在肝海绵状血管瘤（CHL）中的诊断价值。材料和方法：对7例CHL患者行CO2－DSA，其影像表现与常规DSA相比较。结果：7例CHL患者均获得有明显诊断价值的CO2－DSA图像，与常规DSA相比仅1个近右隔顶的小病灶未被显示。CO2－DSA显示瘤体大小、形态及边缘情况较碘剂DSA好，同样可显示出“早出晚归”这一特征性表现。7例CHL－CO2－DSA均在瘤体附近出现门脉分支的显影（7／7），而常规DSA仅有1例显示（1／7）。结论：CO2－DSA可对CHL作出准确诊断，CHL患者CO2－DSA中显示门脉，提示门脉为CHL的主要引流静脉。     

CO2 spray mini-injector for digital subtraction angiography versus PC-controlled injection system: Experiments in dogs

A personal computer (PC)-controlled CO₂ injector (consisting of a pneumatic unit, electric/electronic system, and calculator) and a spray miniinjector (consisting of a CO₂ spray can and a dosage chamber) were used in 10 dogs to determine their efficacy regarding imaging quality and ease of handling. CO₂ was injected into the abdominal aorta, renal artery, and femoral artery. The vessel diameter was determined on each CO₂ arteriogram and compared with that determined on a reference arteriogram obtained using an iodinated contrast agent. The filling ratio (CO₂/iodine) was calculated for each set of injection parameters. Both injection systems provided good visualization (filling ratio >0.9) of large and small arteries within a range of injection parameters. In terms of practicality, the spray miniinjector is more appealing, because it is easier to handle and does not require any preparation.     

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.     

Carbon dioxide (CO2) digital subtraction angiography: 26-year experience at the University of Florida

Although the vascular system is presently being imaged by multiple high technology modalities, contrast angiography continues to be the gold standard; however, severe complications rarely occur. During the last 25 years (in over 1400 patients), CO₂ has proven to be extremely safe (no allergy or renal failure). However, it is imperative to understand CO₂'s physical properties and potential dangers. Recently, CO₂ is being routinely utilized not only because of safety, but for detection of minute amounts of bleeding, better collateral filling, and for most interventional procedures since unlimited volumes of CO₂ can be injected between the catheter and guidewire. Presently, safe, reliable and “user-friendly” delivery systems are now commercially available. CO₂ DSA images are now nearly comparable to iodinated contrast, and improvement in DSA images are evolving, including “stacking” software. Received 10 July 1997; Revision received 9 September 1997; Accepted 15 September 1997     

下肢静脉顺行性CO2 -DSA的临床应用

目的探索经足背静脉行下肢静脉CO2-DSA的可行性及效果。方法15例患者(15条患肢)，男9例，女6例，临床疑为下肢深静脉血栓形成8例，大隐静脉曲张6例，下肢深静脉血栓溶栓术后复查1例。分别用8号头皮针经足背静脉行下肢静脉CO2-DSA。结果12例造影可清晰显示下肢浅、深静脉及其交通支，血栓、血管狭窄的位置及范围，图像质量优；2例造影图像质量良；1例因脚背严重水肿，多次足背静脉穿刺未成功而致造影失败。术中3例无任何不适反应；11例出现下肢一过性不适，主要表现在足背静脉穿刺点处一过性胀痛，其中6例下肢深静脉血栓形成患者感觉明显，停止注射不适感即除；本组未出现重度不良反应或并发症患者。结论下肢静脉顺行性CO2-DSA安全、可行，能够满足临床下肢静脉疾病的诊断要求，尤其是对于髂静脉、下腔静脉的显示效果尤件。     

较大肾上腺嗜铬细胞瘤的MRI及DSA诊断(附6例分析)

目的：评估较大肾上腺嗜铬细胞瘤的ＭＲＩ及ＤＳＡ的诊断价值。材料与方法：６例经手术病理证实的较大肾上腺嗜铬细胞瘤,均行ＭＲ平扫及腹主动脉、肾上腺动脉造影检查。结果：６例ＭＲ表现均为长Ｔ１长Ｔ２信号,２例见囊变和坏死信号。５例主要波及肝右叶和肾上极,１例主要波及胰头并包绕下腔静脉。６例中,４例颖诊嗜铬细胞瘤,２例诊断为巨块型肝癌。ＤＳＡ显示瘤体由肾上腺动脉供血,肿瘤血管丰富,染色浓密,诊断为嗜铬细胞瘤     

CO2—DSA的临床应用研究

目的：探索二氧化碳气体作为血管造影剂的临床应用效果。材料方法：对１６例患者行二氧化碳数字减影血管造影（ＣＯ２－ＤＳＡ）。其中肝动脉造影８例，腹主动脉造影１例，股动脉造影２例，直接门静脉造影３例，肾静脉造影２例，并与同一患者碘剂造影比较。结果：在８例肝肿瘤中，ＣＯ２－ＤＳＡ显示肝动脉－门静脉瘘（ＡＰＦ）６例（６／８），而碘剂显示１例（１／８）。ＣＯ２－ＤＳＡ显示肝内小动脉分支及肿瘤染色不如碘造影剂。但腹主动脉造影、股动脉造影和直接门静脉造影图像较满意，且副作用小。结论：ＣＯ２是一种安全的血管造影剂。ＣＯ２－ＤＳＡ可得到准确、有价值的血管图像，且危险性小。它是显示肝ＡＰＦ的可靠方法     

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)     

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。     

MRA在诊断颅内动脉瘤中的应用

目的：研究MRA诊断颅内动脉瘤的原理与方法，优势与不足以及临床价值。方法：选择经DSA证实为颅内动脉瘤的息者30例，行三维MRA及MRI检查，全部病例均经手术证实。结果：MRA对颅内动脉瘤的敏感性为90％，结合原始断层图像和MRI，敏感性则高达97％，较准确显示了3mm以上动脉瘤的形态、大小及与载瘤动脉的关系。对于检测血栓性动脉瘤MRA优于DSA影像。结论：MRA是一种无创伤的血管检查技术．可准确显示动脉瘤。对于Willis环区动脉瘤，MRA可取代常规血管造影。