数字减影血管造影应用于小儿缺血性脑血管病的诊断与介入治疗

目的 探讨数字减影血管造影(DSA)在小儿缺血性脑血管病中的诊断和介入治疗的价值.方法 31例疑有缺血性脑血管病的患儿经DSA确定部位后,再通过导管注入尿激酶、右旋糖酐以观察注药后血管影像学变化,同时观察临床症状及体征有否改善.结果 31例中24例(77%)示脑血管异常改变,其中脑动静脉畸形2例,后交通动脉瘤1例,大脑动脉狭窄或闭塞病变21例.21例脑动脉狭窄或闭塞病变者行介入灌注治疗后,即刻观察肌力变化有不同程度提高.其中肌力提高Ⅰ级的13例,提高2级的3例,提高3级的2例,无明显改善的3例.即刻肌力提高率达86%.7例狭窄血管100%开通;血管闭塞12例,完全再通3例,部分再通7例,不通2例.结论 DSA能够提高缺血性脑血管病的检出率,是评价脑血管狭窄、闭塞和选择治疗方案的金标准,它对缺血性脑血管病的进一步治疗起着决定性的作用.

The value of digital subtraction angiography in diagnosis and planning endovascular treatment of children with ischemic cerebrovascular diseases

Objective To evaluate the value of digital subtraction angiography(DSA) in diagnosis and planning endovascular treatment of cerebrovascular diseases. Methods Thirty-one children suspected with ischemic cerebrovascular diseases were treated by urokinase and dextran after they underwent DSA.Results Twenty-four cases (77%) had cerebrovascular abnormalities. Two cases had arteriovenous malformations, 1 case had posterior communicating artery aneurysm,21 cases had cerebrovascular stenosis or occlusions. Shortly after intervention therapy using urokinase,muscle strength increased by one level in 13 cases,two levels in 3 cases,3 levels in 2 cases and no effect in 4 cases. The total effective rate reached 86%. Seven patients with ischemic stroke achieved 100% recanalization. Conclusion DSA is very important in diagnosis of cerebrovascular stenosis and occlusion.