目的 提高对创伤性假性动脉瘤并动静脉瘘的影像诊断水平。 方法 报告1例腰椎间盘手术所致的创伤性假性动脉瘤并动静脉瘘，比较分析MRA和DSA对该病的诊断价值。 结果 MRA能够明确创伤性假性动脉瘤及动静脉瘘的诊断，与DSA有良好的相关性。 结论 MRA对创伤性假性动脉瘤并动静脉瘘的确诊有重要价值，在一定程度上能够代替常规血管造影。
目的阐明数字减影血管造影（DSA）监控在区域性置管栓塞化疗治疗肝癌中的重要性。方法比较152例肝癌区域性置管中DSA监控置管与注射美蓝指导下置管的导管位置准确性； 并对术后发生与置管有关的并发症进行分析。结果DSA监控置管准确率肝动脉及门静脉均为100%，注射美蓝指导下置管肝动脉和门静脉的导管位置准确率分别为70.2%和76.1%，两组比较差异有显著性意义（P＜0.01)。术后有导管移位、肝动脉胆管瘘、导管阻塞、药液外漏、硬化性胆管炎等并发症。结论DSA指导下置管准确，又能保证血管内介入治疗的彻底性； 术后行DSA监控，以指导下一步的治疗，并可防止并发症的发生。
Objective To observe the complication after embolizing the bilateral internal il iac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety appl ication of gelfoam in cl inic. Methods Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2females) were randomly divided into 5 groups. Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 μm) in bilateral internal il iac arteries and the main branch of the median sacral artery (group A, n=3), in bilateral internal il iac arteries and the first branch of the median sacral artery (group B, n=3), in the main branch of bilateral internal il iac arteries (group C, n=3), in the unilateral internal il iac artery and the main branch of the median sacral artery (group D, n=4), and in the main branch of unilateral internal il iac artery (group E, n=3). Under the DSA, the anatomic relationships of the abdominal aorta, bilateral external il iac arteries, bilateral internal il iac arteries, and median sacral artery were observed before embol ization. The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization. Results In dogs, there was no common il iac artery; bilateral external il iac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation. Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment. In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL. In survival dogs, no obvious change was observed in the rectum; the bladder only manifested l ight edema; and the median urinary volume in bladder was 137.0, 220.5, and 28.0 mL, respectively in groups B, D, and E.The rectum and bladder of dead dogs in groups A, C, and D manifested the disrupted cells, generous inflammatory cells infiltration, and desquamation of epithel ial cells; the rectum and bladder of survival dogs in groups B, D, and E manifested l ight inflammatory cells infiltration and edema; the embol ized artery mainly focused on the arterioles whose diameter was 100-200 μm. The sciatic nerve and gluteal muscles of each group had no obvious change except for l ight edema. Conclusion When the internal il iac artery and median sacral artery are embol ized with gelfoam particle with a diameter of 50-150 μm, to ensure the safeness of pelvic organs, the embol ized artery can not exceed the first branch when the 3 arteries are embol ized at the same time, or reserve at least unilateral internal il iac artery when embol ized to the trunk , or it will result in pelvic organ necrosis and perforation.
目的:以数字减影血管造影(DSA)为手段,分析短暂性脑缺血发作(TIA)患者临床特点及脑供血动脉狭窄或闭塞的发生率。方法:对 2003 年1月至2007 年8 月期间四川大学华西医院神经内科收治且行DSA检查的短暂性缺血发作患者 65 例进行研究。对患者临床特点,动脉病变情况﹑狭窄程度进行分析.结果:65 例TIA患者中发现血管病变有 38 例(58.5%),其中单侧受累 14 例(21.5%),多处受累 24 例(36.9%),中度及重度,闭塞的血管狭窄多见,且多发生在颅外段。结论:DSA可以明确TIA病患者中血管动脉粥样硬化,狭窄程度,这对指导治疗起重要作用。
ObjectiveTo analysis the risk factors for carotid stenosis in patients with ischemic cerebrovascular disease based on digital subtraction angiography. MethodsA total of 312 patients diagnosed with ischemic cerebrovascular disease who underwent digital subtraction angiography from June 2011 to September 2013 were selected.The risk factors of carotid stenosis were analysised by multivariate logistic regression analysis. ResultsIn 312 patients,271 were with cerebral infarction and 41 were transient ischemic attack patients.There were 149 patients in carotid stenosis group (stenosis degree ≥50%) and 163 patients in control group (stenosis degree<50%).The age (OR=1.037,P=0.000) and coronary heart disease (OR=4.121,P=0.001) were independent risk factors of carotid stenosis with ischemic cerebrovascular disease. ConclusionCarotid stenosis is common in ischemic cerebrovascular disease.Age and coronary heart disease were the independent risk factors.The recognition and control of these risk factors are in favor of secondary prevention of ischemic cerebrovascular disease.
ObjectiveTo explore the features of images by CT,MRI,and MRV for early cranial venous sinus thrombosis (CVST) to provide the diagnostic evidence for choosing an optimal imaging examination. MethodsThe clinical data (imaging features of CT,MRI,and MRV) of 46 patients with CVST diagnosed between January 2009 and January 2013 were retrospectively analyzed. ResultsBrain CT showed the direct signs of CVST in 15 cases (32.6%),and indirect signs of CVST in 8(17.4%).MRI showed the signs of CVST in 17 cases (68.0%);the diagnostic positive rate of MR venography (MRV) combined with MRI was 87.5%,84.6% of which was in line with that of digital subtraction angiography. ConclusionCT can be used as screening tool for those highly suspect CVST cases.MRI combined with MRV show great diagnostic value for CVST.
ObjectiveTo observe the influence of three postoperative analgesia methods on the survival rate of replanted finger by flat digital subtraction angiography (DSA) medical imaging detection system. MethodFrom July 2014 to July 2015, 342 patients were classified into gradeⅠ and gradeⅡ replantation in accordance with their physical condition and they were randomly divided into routine oral group, muscle injection group and analgesia group with 144 patients in each. Flat DSA was used to dynamically observe replantation after revascularization. Then we compared the three different analgesia methods in terms of psychological status of the patients, incidence of vascular crisis, occlusion rate, survival rate of replanted fingers. The function score of replanted fingers was evaluated for clinical efficacy. ResultsCompared with the conventional oral group and muscle injection group, the incidence of vascular crisis in replanted fingers and thrombosis rate were significantly lower in the analgesia group which had a replanted finger survival rate of 96.69% and a normal mental condition rate of 78.07%. Six months after surgery, the rate of excellent and good follow-up was significantly higher than the conventional oral group and muscle injection group (P<0.017) . ConclusionsThe 3-D technology of flat DSA can provide clear and reliable pictures of vessel revascularization status for replanted fingers. The use of continuous brachial plexus analgesia performs better than other methods of analgesia. Good analgesia can stabilize patients' anxiety and negative emotions, which is helpful to avoid excessive fluctuations in blood pressure induced by small artery spasm caused by blood clots and vascular crisis, thereby increasing the survival rate of replanted fingers and facilitating early rehabilitation of their function.
ObjectiveTo investigate the value of head boneless CT angiography (CTA) for surface shaded display (SSD) (hereinafter referred to as the SSD-CTA technology) and volume computed tomographic digital subtraction angiography (VCTDSA) in diagnosing intracranial aneurysms. MethodsWe collected the clinical data of 35 patients diagnosed to have intracranial aneurysm by VCTDSA between April 2013 and November 2014 from the First Affiliated Hospital of Chongqing Medical University. The original data were imported into the CT workstation of the First People's Hospital of Chengdu. Then, SSD-CTA technology was performed for bone reconstruction. We compared the results of these two technologies. In addition, we selected another 27 patients diagnosed with intracranial aneurysm by SSDCTA and DSA examination at the same time between June 2012 and November 2014 in the First People's Hospital of Chengdu for comparison. ResultsThe quality score of SSD-CTA reconstructed image was lower than that of VCTDSA, but the diagnosis of the two technologies for intracranial aneurysm was not statistically different (P>0.05). Compared with DSA, the sensitivity and specificity of the diagnosis for intracranial aneurysms by SSD-CTA were both 100%. ConclusionSSD-CTA is valuable in diagnosing intracranial aneurysms.