肺部体循环动脉CTA在咯血介入治疗中的应用

发布时间：2019-04-19 01:45

【摘要】：目的探讨肺部体循环CTA在咯血介入栓塞治疗中寻找靶血管中的应用价值。方法将48例咯血患者根据介入栓塞术前是否行CTA检查分为CTA组(n=27)和DSA组(n=21)。CTA组术前行肺部体循环CTA检查,将重建图像传至工作站进行后处理,采用MPR、MIP和VR显示可能参与病灶区供血的动脉,根据CTA图像行DSA及介入栓塞治疗。DSA组直接行DSA及介入栓塞治疗。记录支气管动脉开口位置,比较两组术中透视时间、短期(1个月内)和长期(1个月~1年)复发率。结果对48例咯血患者均成功栓塞。CTA组和DSA组术中透视时间分别为(31.29±6.37)min、(36.61±7.49)min,差异有统计学意义(t=-2.658,P0.05)。CTA组和DSA组短期复发率分别3.70%(1/27)、28.57%(6/21),差异有统计学意义(χ2=5.864,P=0.022);长期复发率分别为7.41%(2/27)、14.29%(3/21),差异无统计学意义(χ2=0.599,P=0.379)。所有患者均未出现截瘫、皮肤局部坏死、异位栓塞等严重并发症。结论肺部体循环CTA可准确定位支气管动脉栓塞术中的出血动脉,缩短手术时间,降低短期复发率,为介入手术方案的制定提供重要信息。
[Abstract]:Objective to evaluate the value of pulmonary systemic circulation (CTA) in the treatment of hemoptysis with interventional embolization. Methods 48 patients with hemoptysis were divided into CTA group (n = 27) and DSA group (n = 21). CTA) with pulmonary systemic circulation CTA examination according to whether or not CTA examination was performed before interventional embolization. The reconstructed images were transmitted to workstation for post-processing and MPR, was used for post-processing. MIP and VR showed the arteries that might be involved in the supply of blood in the lesion area. According to the CTA images, DSA and interventional embolization were performed. In the DSA group, DSA and interventional embolization were performed directly. The location of bronchial artery orifice was recorded and the fluoroscopy time, short-term (within 1 month) and long-term (1 month-1 year) recurrence rate were compared between the two groups. Results 48 patients with hemoptysis were successfully embolized. The fluoroscopy time in DSA group and CTA group was (31.29 卤6.37) min, () 36.61 卤7.49 min, respectively (t = 2.658, P < 0.05). The short-term recurrence rates in). CTA group and DSA group were 3.70% (1 / 27) and 28.57% (6 / 21), respectively, with significant difference (蠂 ~ 2 / 5.864, P = 0.022). The long-term recurrence rates were 7.41% (2 / 27) and 14.29% (3 / 21), respectively, with no significant difference (蠂 ~ 2 / 0.599, P = 0.379). No severe complications such as paraplegia, skin necrosis and ectopic embolism were found in all patients. Conclusion CTA of pulmonary systemic circulation can accurately locate the bleeding artery in bronchial artery embolization, shorten the operation time and reduce the short-term recurrence rate, which can provide important information for the formulation of interventional operation plan.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【分类号】：R56;R816.4

【相似文献】