【摘要】 目的探讨急诊经动脉栓塞术中应用锥束CT判定DSA疑似责任动脉是否为大咯血责任动脉的价值。方法回顾性分析接受动脉栓塞治疗的31例大咯血患者的资料。急诊栓塞术中对DSA疑似责任血管行锥束CT成像,根据锥束CT图像判断其是否为肺内靶病灶的供血动脉,从而判定其是否为大咯血责任血管。对经锥束CT判定的责任血管及锥束CT难以确定的疑似责任血管进行栓塞,对经锥束CT判定的非责任血管不予栓塞。结果 31例均于急诊动脉栓塞治疗后24 h内停止咯血。37条动脉为DSA疑似责任动脉;其中29例(29/31,93.55%)患者34条(34/37,91.89%)疑似责任动脉经术中锥束CT可明确鉴定其是否为大咯血责任动脉,包括责任动脉11条(11/37,29.73%)、非责任动脉23条(23/37,62.16%),另2例(2/31,6.45%)患者3条(3/37,8.11%)DSA疑似责任动脉经术中锥束CT仍未明确判定其是否为大咯血责任动脉。结论大咯血急诊经动脉栓塞术中应用锥束CT有助于准确判定DSA疑似责任动脉是否为真正的责任动脉。更多还原

【Abstract】 Objective To observe the value of cone-beam CT(CBCT)for identifying whether the suspected responsibility artery found with DSA was the real responsibility artery of massive hemoptysis during emergent arterial embolization.Methods Data of 31 patients with massive hemoptysis underwent emergent arterial embolization were retrospectively analyzed.CBCT was used for qualitative diagnosis of suspected responsibility artery found with DSA.According to whether it was the feeding vessel of the target lesion in lung on CBCT image,the responsibility artery of massive hemoptysis was determined.Embolization was performed on the definite responsibility artery and the indefinite feeding vessel judged with CBCT,while the irresponsible artery judged with CBCT was not embolized.Results In 31 patients,haemoptysis was stopped within 24 hafter emergent arterial embolization.There were 37 suspected responsibility arteries found with DSA.A total of 34(34/37,91.89%)suspected responsibility arteries in 29(29/31,93.55%)patients were definitely judged whether they were responsibility arteries of massive hemoptysis or not with CBCT,including 11(11/37,29.73%)of definite responsibility arteries and 23(23/37,62.16%)of irresponsible arteries.The other 3(3/37,8.11%)suspected responsibility arteries in 2(2/31,6.45%)patients were indefinite feeding vessels judged with CBCT which were difficult to determined whether they were responsibility arteries or not.Conclusion CBCT is useful to determine whether a suspected responsibility artery is the real responsibility artery of massive hemoptysis during emergent arterial embolization.更多还原