肾出血的多层螺旋CT血管成像诊断与选择性肾动脉栓塞止血治疗

目的 探讨肾出血的多层螺旋CT血管成像（MSCTA）诊断与选择性肾动脉栓塞止血治疗价值.方法 32例肾出血患者均行MSCTA检查,并行PVA颗粒和弹簧圈选择性肾动脉栓塞治疗.结果 32例肾出血患者经MSC-TA检查均能获得明确的诊断,27例可见对比剂外溢,16例可见假性动脉瘤形成,动静脉瘘形成者9例.27例肾出血患者均经PVA颗粒加弹簧圈栓塞,单纯PVA颗粒栓塞5例.20例随访了3～ 25个月,无血尿等症状复发.结论 MSCTA有利于指导肾出血的诊断与治疗,选择性肾动栓塞术是一种微创的疗效可靠的治疗手段.

Multi-slice CT Angiography Diagnosis and Selective Renal Artery Embolization for Renal Hemorrhage

Objective To explore the value of Multi-slice CT angiography （MSCTA）diagnosis and clarify the therapeutic effect,indications and some experiences of selective renal artery embolization for renal hemorrhage.Methods 32 patients with renal hemorrhage （20 men,12 woman;aged from 9 ～57 years;average age,32.5 ± 11.9 years） underwent MSCTA examinations and interventional therapy were analyzed retrospectively.All patients underwent MSCTA examinations and selective renal artery embolization.Embolization materials used in this study were PVA and steel coils.Results Of the 32 patients who underwent MSCTA,all of them had positive findings：27 cases with contrast medium extravasated,16 cases with renal artery pseudoaneurysm and 9 cases with arteriovenou sfistula alone.The correct diagnoses were obtained through the MSCTA.There were 27 cases embolized with PVA and steel coils,with only PVA in 5 cases.All of them were performed successfully.Twenty patients were no recurrence of renal hemorrhage with a mean follow-up of 14 months （range from 3 ～ 25 months）.Conclusion MSCTA is one of the ideal and reliable methods used to diagnose and guide the interventional treatment for the renal hemorrhage,and the selective renal artery embolization is a microtraumatic and effective way for the renal hemorrhage.