低速低劑量顯影劑運用在多切面電腦斷層血管攝影術對血液透析動靜脈管之評估

Multislice Computed Tomographic Angiography for the Evaluation of Hemodialysis Arterio-venous Fistula with Reduced Volume and Low Injection Flow-rate of Contrast Mediums

李榮輝(Jung-Hui Li) ； 高常發(Sheung-Fat Ko) ； 趙世裕(Shih-Yu Chao)

《中華放射線技術學雜誌》 29卷2期 (2005/12) Pp. 147-154

https://doi.org/10.30045/CJRT.200512.0004

摘要

洗腎慢性腎病病人，常使用動靜脈瘻管(Arteriovenous fistula, AVF)作為血路入口，但因長期重複扎針及高速血流通過，致使瘻管功能不良或其他併發症產生。因此，我們利用多切面電腦斷層掃描儀(multisliceCT, MSCT)來對血液透析動靜脈瘻管病人進行新方式的評估檢查。本檢查為前瞻性的研究，在92年8月1日起到93年7月31日間，我們對25位因動靜脈瘻管功能不良或合併其他病變而需作術前評估之病人，進行電腦斷層血管造影及數位血管造影，並且對照手術中之發現，去評估multislice CT對AVF的臨床應用。我們發現，以較低速率注射較少劑量之顯影劑作CTA對血液透析之病人的動靜脈瘻管仍可有十分準確顯示出動靜脈瘻管解剖結構及其併發症。

關鍵字

多切面多列探頭電腦斷層 ； 動靜脈瘻管 ； 血管造影

並列摘要

Arteriovenous fistulas (AVFs) are most commonly applied means of vascular access for long-term hemodialysis in patients with end stage renal disease. Repeated punctures of the AVF for hemodialysis and high flow through the fistula may lead to various complications or fistula dysfunction. We postulate that multislice CTA with reduced volume of contrast material (100ml) and a low injection flow-rate (＜2.5ml/sec) may be feasible in good delineation of the hemodialysis AVFs. In this prospective study, we have recruited 25 patients with AVF dysfunction or AVF-related complications for preoperative planning. CTA and digital subtraction angiography were performed and correlated with surgical findings to assess the clinical usefulness of multislice CTA for surgical planning of dysfunction AVFs. The hypothesis that reduced volume and low injection flow rate of contrast materials could allow accurate noninvasive delineation of various AVF-related complications was verified.

並列關鍵字

Multi-slice Computed tomography MSCT ； arterio-venous fistula AVF ； angiography