鼻咽癌放疗后出血介入诊疗中DSA图像质量控制

目的探讨鼻咽癌放疗后出血介入诊疗中DSA图像质量控制。方法 2000年4月至2010年3月共完成56例选择性血管栓塞治疗鼻咽癌放疗后鼻咽出血,使用数字减影血管造影（DSA）检查,对鼻咽部侧位动态影像进行影像质量评价：分为能明确出血动脉、出血部位和不能明确病变供血血管两组。结果 56例患者中42例可见明确对比剂外溢和肿瘤血管征象,明确出血责任动脉,进行介入栓塞治疗,取得显著的止血效果。14例需加其它体位和方法才能明确诊断。结论通过选择合适技术参数：即患者的相对体位、对比剂技术参数的设定、图象后处理技术等对确保鼻咽癌放疗后出血介入诊疗图像质量十分重要。

DSA images quality control for invasive diagnosis and treatment of serious epistaxis in nasopharyngeal carcinoma after radiotherapy

Objective To investigate the DSA images quality control and evaluate its clinical application in the treatment of serious epistaxis in patients with nasopharyngeal carcinoma after radiotherapy.Methods Between April 2000 and March 2010, 56 patients with nasopharyngeal carcinoma occurred serious epistaxis after radiotherapy had selective angiography of the internal and external carotid, and images were obtained with the digital subtraction angiography（DSA）. Lateral images of each anatomical region were classified as being ＂diagnostic＂, i.e. images sufficient to make a decision on management, or ＂poor＂, If the two observers differed.Results 42 satisfied DSA images were obtained among 56, which show the tumor angiogenesis extravagated contrast material and vascular involvement. The bleeding site and target arteries were indentified, and the hemorrhage was successfully stopped through interventional therapy. Positive symptoms were not seen in 14 cases, or extra views were necessary.Conclusion Reasonable setting DSA technical data, including the body position in X-ray radiography, the contrast medium injection parameters, images special procedures, are the key to obtain better image and the base of interventional examination in the DSA examination of serious epistaxis in nasopharyngeal carcinoma after radiotherapy.