腹主動脈瘤之血管攝影檢查

Angiography of Abdominal Aortic Aneurysm

吳峻吉(Chun-Chi Wu)

《中華放射線醫學雜誌》 1卷4期 (1976/12) Pp. 217-222

摘要

腹主動脈瘤之診斷最主要為臨床上之徵象，如腹部有跳動性之腫塊卽可臆斷。血管攝影之價值在明確顯示腹主動脈瘤之大小、形狀及位置因而決定手術之可行性。體積較小的動脈瘤，臨床徵象不清，則端賴血管攝影始可診斷。腹主動脈攝影，由股動脈作檢查，雖導管、導線等需通過有栓塞或動脈瘤之血管，但本文所報告17位病例之經驗，尚無發生血栓之游走或動脈瘤之破裂等技術性之併發症，且動脈瘤與腎血管之關係可經由此法明確地顯示。對手術之可行性及選擇性幫助較大，故在手術前均應先試用此法以檢查動脈瘤，懷疑有腹主動脈瘤破裂時，應立即施行腹部一般正面及側面X光片詳加研究，不宜作血管攝影以求證。

並列摘要

Angiogram for diagnosis of abdominal aortic aneurysms is not always essential because a pulsatile expansible abdominal mass is usually sufficient. But angiogram has the advantages of preoperative determinations of the size, shape and location of the abdominal aortic aneurysm and state of the run-off.
A small aneurysm with no infallible clinic sign can also be demonstrated and diagnosed by angiogram.
Even though there is reluctance to pass metallic wires, springs and catheters through the thrombotic and aneurysmal vascular sesment, percutaneous femoral aortography has been performed in our department without dislodgement of the thrombotic material and none has the iartogenic aortic rupture. The aortogram can accurately demonstrate the relationship of the renal vessel and aortic aneurysm. This method is more helpful to the sargeon for preoperative evaluation.
Death is inevitable after rupture of an abdominal aortic aneurysm unless operation is immediately performed. The diagnosis of ruptured aneurysm of the abdominal aorta depends on a careful examination and a high index of suspicion. The most useful investigation is a plain KUB and lateral view of the abdomen. Aortogram rarely shows a leaking aneurysm.