Objective: To investigate the imaging features and clinical significance of carbon dioxide digital subtraction angiography (CO2-DSA) in the diagnosis and treatment of hepatocellular carcinoma (HCC). Methods: Both CO2-...Objective: To investigate the imaging features and clinical significance of carbon dioxide digital subtraction angiography (CO2-DSA) in the diagnosis and treatment of hepatocellular carcinoma (HCC). Methods: Both CO2-DSA and conventional DSA were performed in all 47 patients with HCC, and the angio-graphic manifestations of CO2-DSA were compared with those of conventional DSA in the same patients. Results: Peripheral arterial and capillary imaging by CO2-DSA was inferior to that by conventional DSA, although blood pools were well visualized with CO2. Improved visualization of arterioportal shunting (APS) was obtained with CO2-DSA compared with that by conventional angiography. APS was observed in 33 cases by CO2-DSA and in 12 cases by conventional angiography (P<0. 001). Retrograde visualization of the portal vein (PV) trunk and its large branches was demonstrated in 16 cases by CO2-DSA and in 1 case by conventional DSA (P<0. 001). The manifestation of lipiodol retention in the tumors was consistent with CO2-DSA images after TAE in 38 cases, and with those of conventional DSA in 23 cases (P<0. 01). Conclusion: CO2-DSA was superior to conventional DSA in the detection of APS and retrograde visualization of PV system, and the former can provide usefulness information for the treatment planning (chemoembolization) and patient prognosis. Demonstration of APS by CO2-DSA may suggest the presence of intrahepatic metastases.展开更多
Objective: To evaluate the value of digital subtraction angiography (DSA) in management of endovascular graft exclusion (EVGE) for abdominal aortic aneurysms. Methods: Monitored by DSA and fluoroscopy, stent-graft com...Objective: To evaluate the value of digital subtraction angiography (DSA) in management of endovascular graft exclusion (EVGE) for abdominal aortic aneurysms. Methods: Monitored by DSA and fluoroscopy, stent-graft complex were introduced into the aneurysm sac via femoral arteries and were deployed at the proximal and distal necks to exclude the sac from circulation. Results: The success rate of deployment was 94. 74% (36/38). Endoleaks occurred in 4 cases. One converted to open surgery because of sac rupture 4 days after deployment. Thrombosis and stenosis occurred in 2 cases. Three patients died shortly after the operation (< 3 months). Conclusion: DSA can monitor EVCE on real-time throughout the whole procedure. It can meet the needs of measurement, location, evaluating, detecting, and also can be much helpful in correcting complications. Moreover, it provides large visual field and operating space, and is a very important monitoring method for EVGE.展开更多
Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL) presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the ...Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL) presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the diagnosis of CHL. Methods: Both CO2-DSA and iodinated contrast DSA (IC-DSA) were performed in all 16 patients with CHL, and the angiographic manifestations in the same patients were compared. The image quality was rated by three experienced angiographers, and the complications were also assessed. Results: There was good correlation between angiographers on image quality (R = 0. 73). Diagnostic images were obtained with both CO2-DSA and IC-DSA in all CHL patients. No difference was noted between IC-DSA and CO2-DSA in visualizing the proper hepatic arteries and its branches (P>0. 05). CO2-DSA produced better images that clearly described the tumor size, shape and margination than those by IC-DSA (P< 0. 05), but both demonstrated characteristic appearances of early opacification and persistent contrast enhancement of the tumors. The portal vein branches near the tumors were constantly demonstrated by CO2-DSA in 15 cases (15/16) but only in 2 cases (2/16) by IC-DSA. Conclusion: CO2-DSA is sensitive in CHL diagnosis, and in patients with contraindications to IC or with unsatisfactory imaging results by IC-DSA, CO2-DSA is a good alternative. As show in most cases by CO2-DSA, the portal veins might act as the main drainage vein of CHLs.展开更多
目的探讨CT血管造影(CTA)与多普勒超声(DUS)检查在下肢动脉硬化性闭塞症(ASO)中的诊断效能。方法选取我院经数字减影血管造影(DSA)检查并接受腔内血管成形术治疗的80例ASO患者。以DSA作为金标准,对比患者术前CTA及DUS诊断ASO的效能及一...目的探讨CT血管造影(CTA)与多普勒超声(DUS)检查在下肢动脉硬化性闭塞症(ASO)中的诊断效能。方法选取我院经数字减影血管造影(DSA)检查并接受腔内血管成形术治疗的80例ASO患者。以DSA作为金标准,对比患者术前CTA及DUS诊断ASO的效能及一致性。结果CTA对全段下肢动脉及髂动脉段≥50%血管狭窄及闭塞的检出率分别较DUS高4.89%(P=0.002)和2.29%(P=0.007)。CTA对下肢全段≥50%血管狭窄及腘上动脉段管腔闭塞的诊断效能及一致性均高于DUS(敏感性:81.47%~96.84%vs 80.35%~89.66%;特异性82.39%~90.75%vs 82.16%~87.25%;Kappa值:0.82~0.98 vs 0.79~0.94),而对腘下动脉段血管闭塞的评估表现不及DUS(敏感性:77.83%vs 78.49%;特异性:72.15%vs 79.28%;Kappa值:0.72 vs 0.76)。结论CTA对ASO患者的血管评估效能总体优于DUS,而对于腘下动脉段血管重度狭窄及闭塞仍需联合DUS综合评估,以制定最佳临床治疗方案。展开更多
文摘Objective: To investigate the imaging features and clinical significance of carbon dioxide digital subtraction angiography (CO2-DSA) in the diagnosis and treatment of hepatocellular carcinoma (HCC). Methods: Both CO2-DSA and conventional DSA were performed in all 47 patients with HCC, and the angio-graphic manifestations of CO2-DSA were compared with those of conventional DSA in the same patients. Results: Peripheral arterial and capillary imaging by CO2-DSA was inferior to that by conventional DSA, although blood pools were well visualized with CO2. Improved visualization of arterioportal shunting (APS) was obtained with CO2-DSA compared with that by conventional angiography. APS was observed in 33 cases by CO2-DSA and in 12 cases by conventional angiography (P<0. 001). Retrograde visualization of the portal vein (PV) trunk and its large branches was demonstrated in 16 cases by CO2-DSA and in 1 case by conventional DSA (P<0. 001). The manifestation of lipiodol retention in the tumors was consistent with CO2-DSA images after TAE in 38 cases, and with those of conventional DSA in 23 cases (P<0. 01). Conclusion: CO2-DSA was superior to conventional DSA in the detection of APS and retrograde visualization of PV system, and the former can provide usefulness information for the treatment planning (chemoembolization) and patient prognosis. Demonstration of APS by CO2-DSA may suggest the presence of intrahepatic metastases.
文摘Objective: To evaluate the value of digital subtraction angiography (DSA) in management of endovascular graft exclusion (EVGE) for abdominal aortic aneurysms. Methods: Monitored by DSA and fluoroscopy, stent-graft complex were introduced into the aneurysm sac via femoral arteries and were deployed at the proximal and distal necks to exclude the sac from circulation. Results: The success rate of deployment was 94. 74% (36/38). Endoleaks occurred in 4 cases. One converted to open surgery because of sac rupture 4 days after deployment. Thrombosis and stenosis occurred in 2 cases. Three patients died shortly after the operation (< 3 months). Conclusion: DSA can monitor EVCE on real-time throughout the whole procedure. It can meet the needs of measurement, location, evaluating, detecting, and also can be much helpful in correcting complications. Moreover, it provides large visual field and operating space, and is a very important monitoring method for EVGE.
文摘Objective: To describe the characteristic appearance of cavernous hemangioma of the liver (CHL) presented in carbon dioxide digital subtraction angiography (CO2-DSA) and to evaluate the significance of CO2-DSA in the diagnosis of CHL. Methods: Both CO2-DSA and iodinated contrast DSA (IC-DSA) were performed in all 16 patients with CHL, and the angiographic manifestations in the same patients were compared. The image quality was rated by three experienced angiographers, and the complications were also assessed. Results: There was good correlation between angiographers on image quality (R = 0. 73). Diagnostic images were obtained with both CO2-DSA and IC-DSA in all CHL patients. No difference was noted between IC-DSA and CO2-DSA in visualizing the proper hepatic arteries and its branches (P>0. 05). CO2-DSA produced better images that clearly described the tumor size, shape and margination than those by IC-DSA (P< 0. 05), but both demonstrated characteristic appearances of early opacification and persistent contrast enhancement of the tumors. The portal vein branches near the tumors were constantly demonstrated by CO2-DSA in 15 cases (15/16) but only in 2 cases (2/16) by IC-DSA. Conclusion: CO2-DSA is sensitive in CHL diagnosis, and in patients with contraindications to IC or with unsatisfactory imaging results by IC-DSA, CO2-DSA is a good alternative. As show in most cases by CO2-DSA, the portal veins might act as the main drainage vein of CHLs.
文摘目的探讨CT血管造影(CTA)与多普勒超声(DUS)检查在下肢动脉硬化性闭塞症(ASO)中的诊断效能。方法选取我院经数字减影血管造影(DSA)检查并接受腔内血管成形术治疗的80例ASO患者。以DSA作为金标准,对比患者术前CTA及DUS诊断ASO的效能及一致性。结果CTA对全段下肢动脉及髂动脉段≥50%血管狭窄及闭塞的检出率分别较DUS高4.89%(P=0.002)和2.29%(P=0.007)。CTA对下肢全段≥50%血管狭窄及腘上动脉段管腔闭塞的诊断效能及一致性均高于DUS(敏感性:81.47%~96.84%vs 80.35%~89.66%;特异性82.39%~90.75%vs 82.16%~87.25%;Kappa值:0.82~0.98 vs 0.79~0.94),而对腘下动脉段血管闭塞的评估表现不及DUS(敏感性:77.83%vs 78.49%;特异性:72.15%vs 79.28%;Kappa值:0.72 vs 0.76)。结论CTA对ASO患者的血管评估效能总体优于DUS,而对于腘下动脉段血管重度狭窄及闭塞仍需联合DUS综合评估,以制定最佳临床治疗方案。
