论文部分内容阅读
目的:探讨磁共振血管造影(MRA)以及计算机断层扫描血管成像(CTA)对地震挤压伤下肢血管病变的临床价值。方法:对5.12汶川大地震中我院收治的已确诊为地震挤压伤致双下肢横纹肌溶解症3例患者进行双下肢MRA检查,并对严重挤压伤及下肢毁损,并行截肢的另三名患者进行术后CTA检查。对MRA图象双下肢动脉进行回顾性分析,总结MRA征象,同时总结截肢术后患者CTA表现及临床价值,并评价二者检查在挤压伤所至横纹肌溶解症的临床诊治中的作用。结果:3例未行截肢患者MRA双下肢主要动脉未见确切狭窄及闭塞征象,管腔内未见充盈缺损影。3例已行截肢患者可见残余肢体的明显肿胀,双侧髂血管以及部分截断肢体远端血管内见止血弹簧钢圈影像,部分截断肢体远端动脉分支变细。截断血管未见再通,周围无渗血改变。结论:MRA、CTA能直观显示双下肢动脉损伤及术后情况,在临床应用中各有优势和局限性。对二者的合理选择能为临床诊治提供有利信息。
Objective: To investigate the clinical value of magnetic resonance angiography (MRA) and computed tomography angiography (CTA) on vascular lesions of lower extremities under earthquake crush injury. Methods: Three cases of double lower extremity MRA were examined in 3 cases of double lower extremity rhabdomyolysis diagnosed as earthquake crushing injuries in our hospital during the 5.12 Wenchuan earthquake. Three other amputations were severely crushed and injured Patients underwent CTA examination. The MRA images of both lower extremity arteries were retrospectively analyzed to summarize the signs of MRA. CTA findings and clinical values of patients after amputation were summarized. The roles of the two in the clinical diagnosis and treatment of rhabdomyolysis were also evaluated. Results: There were no obvious signs of stenosis and occlusion in the main arteries of the lower limbs of MRA in 3 cases without amputation. No filling defect was found in the lumen. Three cases of amputation patients have visible swelling of the remnant limbs, bilateral iliac vessels and distal trocar part of the limbs see the hemostatic spring steel ring image, part of the truncated limb distal artery thinning. Cut off the blood vessels no recanalization, no changes in the oozing around. Conclusion: MRA and CTA can directly show the arterial injury and postoperative condition of both lower extremities. They have their own advantages and limitations in clinical application. The reasonable choice of both can provide favorable information for clinical diagnosis and treatment.