256层iCT全景血管成像评价上肢动静脉内瘘功能不全

发布时间：2018-03-29 17:32

本文选题：血液透析　切入点：动静脉内瘘　出处：《放射学实践》2017年09期

【摘要】：目的:探讨256层iCT全景血管成像在评估血液透析患者自体内瘘血管功能不全中的价值。方法:36例血液透析并血管通路功能不全患者采用256层iCT进行造瘘侧上肢血管成像,采用对比剂追踪及智能触发扫描技术,对原始图像采用容积再现(VR)、最大密度投影(MIP)、曲面重组(CPR)等技术进行后处理,获取内瘘血管的二维及三维图像。结果:36例患者均顺利完成CT血管成像检查,能清晰显示内瘘血管全程,内瘘血管并发症,病变部位、范围、狭窄程度及侧支循环形成情况。36例患者中单纯流入性动脉狭窄4例,其中多发节段性狭窄2例;单纯吻合口狭窄7例;单纯流出性静脉狭窄6例;流入性动脉+吻合口狭窄6例,吻合口+流出性静脉狭窄6例,流入性动脉+吻合口+流出性静脉狭窄4例,流入性动脉+流出性静脉狭窄3例。36例患者中合并附壁血栓16例,引流静脉瘤样变或节段性扩长、扩张8例,串珠样改变4例,9例患肢软组织肿胀伴发不同程度侧支循环形成。结论:全景CTA可以清晰显示瘘血管全程,能对内瘘血管的并发症进行准确诊断,为临床治疗提供指导。
[Abstract]:Objective: to evaluate the value of 256-layer iCT panoramic angiography in evaluating vascular insufficiency of fistula in hemodialysis patients. By using contrast agent tracing and intelligent trigger scanning technology, the original image was processed by volume reproducing VRV, maximum density projection MIPX, curved surface recombination and CPR, etc. Results CT angiography was successfully completed in 36 patients with internal fistula, which could clearly show the whole course of internal fistula, the complications of internal fistula, the location and range of lesion. The degree of stenosis and the formation of collateral circulation in 36 cases were only inflow stenosis in 4 cases, including multiple segmental stenosis in 2 cases, simple anastomotic stenosis in 7 cases, simple outflow vein stenosis in 6 cases; There were 6 cases of anastomotic stenosis of inflow artery, 6 cases of anastomotic outflow vein stenosis, 4 cases of inflow artery anastomotic outflow vein stenosis, 3 cases of inflow artery outflow vein stenosis, and 16 cases of mural thrombosis. The drainage vein was tumor-like or segmental dilated in 8 cases and beaded in 4 cases with soft tissue swelling and collateral circulation formation in 9 cases. Conclusion: panoramic CTA can clearly show the whole course of fistula. It can accurately diagnose the complications of internal fistula and provide guidance for clinical treatment.
【作者单位】：佛山市第一人民医院影像科;
【基金】：佛山市科技创新平台项目(2015AG10004) 佛山市医学重点专科培育项目建设(Fspy3-2015013)
【分类号】：R459.5;R816.2

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