MRA及CTA对地震挤压伤血管病变的诊断价值及术后评价

目的：探讨磁共振血管造影（MRA）以及计算机断层扫描血管成像（CTA）对地震挤压伤下肢血管病变的临床价值。方法：对5·12汶川大地震中我院收治的已确诊为地震挤压伤致双下肢横纹肌溶解症3例患者进行双下肢MRA检查，并对严重挤压伤及下肢毁损，并行截肢的另三名患者进行术后CTA检查。对MRA图象双下肢动脉进行回顾性分析，总结MRA征象，同时总结截肢术后患者CTA表现及临床价值，并评价二者检查在挤压伤所至横纹肌溶解症的临床诊治中的作用。结果：3例未行截肢患者MRA双下肢主要动脉未见确切狭窄及闭塞征象，管腔内未见充盈缺损影。3例已行截肢患者可见残余肢体的明显肿胀，双侧髂血管以及部分截断肢体远端血管内见止血弹簧钢圈影像，部分截断肢体远端动脉分支变细。截断血管未见再通，周围无渗血改变。结论：MRA、CTA能直观显示双下肢动脉损伤及术后情况，在临床应用中各有优势和局限性。对二者的合理选择能为临床诊治提供有利信息。

Diagnostic Value and Post-operative Evaluation of MRA and CTA in Vascular Lesions of Low Extremity Caused by Crush Injury after Earthquake

Objective：To evaluate the application of Magnetic Resonance Angiography（MRA）and computed tomography Angiography（CTA）in vesselar lesions of low extremities caused by crush injury after Wenchuan earthquake. Methods：MRA was performed on three patients with crush injury, and CTA was performed on other three patients with sever severe crush injury after amputation. We retrospectively evaluated the MRA and CTA images as well as the their clinic application and values on crush injury. Results： There are no signs of arterial occlusion.arteriostenosis and filling defect on MRA of three patients. CTA showed clearly the blockage of main artery in stump and the thinning of blood vessels in stump as well as swelling in soft tissue. Conclusion： MRA and CTA both can directly display the conditions of vascular lesions and the post-operation, so they are very important and useful technique in the diagnosis and guidance of treatment of crush injury,but with different indications and limitations which should be selectively used in different conditions.