旋转DSA技术在子宫肌瘤介入治疗中的应用.doc

旋转DSA技术在子宫肌瘤介入治疗中的应用 【关键词】 旋转DSA 摘要：目的：探讨旋转数字减影血管造影（ＤＳＡ）技术在子宫肌瘤介入治疗中的应用价值。方法：采用GE Advantax LCV/DXL DSA系统对25例子宫肌瘤患者行旋转DSA检查。结果：旋转DSA技术能够清晰显示复杂的子宫动脉开口及走行，为导管的准确插入提供可靠的插入角度。25例患者栓塞治疗成功率100 %，无严重并发症发生。结论：旋转DSA能够多方位清楚地显示复杂开口的子宫动脉，对提高超选择性插管的成功率和降低手术操作时间有着重要意义，是一种有价值的检查方法。 关键词：数字减影血管造影；子宫肌瘤栓塞术；介入治疗 Application of rotational DSA in interventional therapy of uterine fibroidsＷNAG Jian，LIU Hongwei，REN Weixin (Department of Radiology, Fifth Affiliated Hospital, Xinjiang Medical University, Urumqi 830011 , China) Abstract: Objective: To evaluate the value of rotational digtal subtraction angiography(DSA) in the interventional therapy for uterine fibroids (UF). Methods: With GE Advantax LCV/DXL unit, rotational DSA angiography were performed in 25 patients with UF so as to well display the complex uterine arterial position. Results: Rotational DSA angiography clearly displayed the complex uterine arterial sites and applied for reliable angle to insert catheter. All 25 patients underwent technically successful embolization. No serious complication related to the procedure had occurred. Conclusions: Rotational DSA angiography can not only display the complex uterine arterial from different angle to improve the successful rate of super selective catheterization but to decrease interventional therapy times . This method is important and available. Key words: digtal subtraction angiography(DSA); uterine fibroids embolization; interventional therapy 子宫肌瘤(UF)是妇女常见的盆腔良性肿瘤，20%～40 %的育龄妇女可发生UF,　在妇科非急性出血病因中，UF 据首位［1］。近年来，经导管子宫动脉栓塞术（UAE）治疗UF已被广大患者所接受，疗效较好。但是，对于子宫动脉开口位置变异的患者，传统的正位数字减影血管造影（DSA）技术因髂内动脉各分支血管的重叠，使术者难以正确判断其开口位置，为选择性子宫动脉插管治疗增加了困难。我科2002～2004年对25例UF患者在行子宫动脉栓塞术前行髂内动脉旋转DSA检查，现报道如下。 1资料与方法 1.1临床资料本组25例UF患者，年龄35～48岁，平均40岁,均为经临床及Ｂ超、ＣＴ检查确诊并拟行经导管子宫动脉栓塞术的患者。其中粘膜下肌瘤3例，肌壁间肌瘤22例，肌瘤大小平均52.3 mm×119.2 mm, 5例单发，20例多发。 1.2方法常规行右侧股动脉穿刺插管，在超滑导丝的引导下，将5F Cobra管置于左侧髂内动脉处，撤出导丝，导管尾部连接高压注射器，对比剂选用优维显300 mg I/ml，总量15～20 ml，流速4～5 ml/s，应用GE Advantax LCV/DXL DSA系统的旋转功能，将X线管置于左前斜位（LAO）40°，透视下定位并设为起始位，旋转球