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CO2 angiography of vascular access in hemodialysis: a preliminary report
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1005-1201.2005.04.009
- Key Word:
- 二氧化碳;血管造影术,数字减影;肾透析
Abstract： 目的探讨CO2血管造影在血液透析的血管通路评价中的应用技术及其价值.方法对10例慢性肾衰经桡动脉内瘘进行血液透析的患者进行CO2静脉造影,7例于内瘘远侧手背静脉穿刺,3例直接行内瘘穿刺,快速推注CO2每次40～60 ml,完成到上腔静脉的全程引流静脉造影,并于肘部加压后完成1次前臂静脉造影.使用Toshiba Infinix Vc-i 旋转DSA机,直接以减影模式实时显示,并对图像作叠加处理.结果所有病人均顺利安全地完成检查,静脉表现为流畅连续的管状结构或显示为一连串气泡,7例手背静脉进针中仅1例清晰显示粗大的引流头静脉,其余显示了较多旁支;3例经内瘘直接进针,均清晰显示引流的头静脉,旁支稀少.5例手背静脉进针加压后造影显示2例头静脉发生变化,其余未见明显变化.所有上臂段头静脉,以及腋静脉、锁骨下静脉均显示较清晰,叠加后图像更好地显示了连续流畅的血管.结论血管通路CO2静脉造影是安全经济和快速有效的手段;肾衰病人血管通路引流静脉有其自身特点,内瘘直接穿刺造影是引流静脉造影的最佳途径,充分利用各种技巧能够更好地显示靶血管及其病变.
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