论文部分内容阅读
目的总结肾损伤出血的DSA血管造影表现,并探讨对治疗方式选择的意义。方法自2001—2007年对14例肾损伤血尿患者进行超选择性肾动脉造影,其中医源性肾脏损伤11例,肾脏外伤3例。6例血流动力学指标不稳定。结果7例出血动脉为肾段动脉的分支叶间动脉或弓形动脉近端,DSA显示对比剂外溢迅速、量大,出血灶远离肾周边缘,表现为动脉肾盂瘘4例、动脉静脉瘘1例、动脉肾盂瘘合并动脉静脉瘘2例,2例伴假性动脉瘤。7例出血动脉为弓形动脉远端及分支小叶间动脉。DSA表现为局限对比剂外溢,多位于肾皮质,肾实质局限异常染色,造影剂滞留至肾实质期仍不消退,均未见明显动脉静脉瘘或动脉肾盂瘘。结论DSA检查对肾损伤出血的诊断和治疗有重要帮助。
Objective To summarize the manifestations of DSA angiography in patients with renal injury and to explore the significance of treatment options. Methods From 2001 to 2007, 14 patients with renal injury and hematuria were subjected to hypersensitivity renal angiography, including 11 cases of iatrogenic renal injury and 3 cases of renal trauma. 6 cases of hemodynamic instability. Results Seven cases of hemorrhage artery were the branches of the branch arteries or the proximal segments of the arcuate artery. The DSA showed that the contrast agent overflowed rapidly and the amount was large. The hemorrhage foci were away from the pericardial border, which showed arterial fistula in 4 cases and arteriovenous fistula in 1 case Arterial fistula with arteriovenous fistula in 2 cases and 2 cases with pseudoaneurysm. Seven cases of bleeding artery for the distal segment of the arcuate artery and branch interlobular arteries. DSA showed limited contrast agent spillover, mostly located in the renal cortex, abnormal renal parenchymal staining, contrast agent retention to the renal parenchyma is still not subsided, no obvious arterial venous fistula or arterial fistula. Conclusion DSA examination is helpful for the diagnosis and treatment of renal injury and bleeding.