急慢性空回肠出血DSA检查的临床价值

目的 探讨急慢性空回肠出血患者的DSA检查，进一步提高其临床应用价值。方法 回顾性分析26例行肠系膜上动脉DSA造影的空回肠出血的患者的DSA表现，并与手术及病理所见进行对照分析。结果 DSA检查阳性有20例，总阳性率76．9％，间质瘤(平滑肌瘤，肉瘤，纤维瘤)6例，腺瘤(癌)5例，DSA表现为肿瘤血管，肿瘤染色，静脉早显，造影剂外溢不显著。转移瘤3例，造影剂呈小点状、环形聚集。血管畸形4例，显示扭曲、增粗、不规则的畸形血管及增粗引流静脉。憩事3例，表现为造影剂浓集区。坏死性小肠炎2例，表现为血管影密集。结论 DSA检查对于急性、慢性空回肠出血的诊断价值很大，尤其是对于肿瘤性病变和血管畸形的定性定位准确。

The clinical value of DSA in the acute and chronic jejun-ilealintestine hemorrhage

Objective To investigate digital substractionangiography of the acute and chronic jejuno ilel intestine hemorrhage,and to improve its clinical application. Methods Selective superior mesentericangiography in 26 cases were retrospecfirety studied and comparedwith surgical and pathologic findings. Results DSA was positive in20 cases(76.9%): 6 cases of mesenchymoma(leiomyma,fibroma and sarcoma); and 5 cases of adenoma or adenal carcinoma. DSA demonstrated the vascularity of tumors and early opacificationof the draining vein. The extravasation of the contrast media was not revealed.Panctate or circle opacification was revealed in 2 cases of mestastases out of 3. Vascular malformation was found in 4 cases, DSA showed enlarged and tortuous vascularity imagings and large draining veins. In necrotizing jejunitis anddiverticulum, DSA showed hyper vascular lesions or abnormal opacification.Conclusion DSA plays an important role in localization and diagnosis ofacute and chronic jejuno ileal hemorrhage, espeacialy in the neoplasmic lesions and the vascular malformation.