- 期刊
Peripheral VA葉克膜受檢者之腦部電腦斷層血管攝影－案例報告
Brain Computed Tomography Angiography in Patients with Peripheral VA ECMO-A Case Report
摘要
腦部電腦斷層血管攝影（brain computed tomography angiography, Brain CTA）為目前診斷顱內血管最為快速且非侵襲性的方式，許多心臟手術後的患者因為心臟功能尚未完全恢復，所以在術後會裝有暫時取代心肺循環的體外循環心肺支持系統，即是葉克膜（extracorporeal membrane oxygenation，ECMO），部分裝有葉克膜的患者因為臨床上的表徵而被懷疑有腦部血管的病變，因此會被安排做一腦部電腦斷層血管攝影。本次報告為64歲男性，因冠狀動脈的疾病前來做冠狀動脈繞道術（coronary artery bypass graft, CABG），術後此病患被裝上peripheral veno-arterial（VA）ECMO，在加護病房照護時因全身僵直陣孿性癲癇（General Tonic-Clonic Seizure，GTC）故被安排一頭部電腦斷層血管攝影，此案例目的在呈現因VA葉克膜會造成血液動力上的改變，對比劑於右側的腦部血管會形成充盈上的缺陷，在臨床的判斷及技術上的調整使最終的影像結果優化並可協助醫師在影像上的判讀。
並列摘要
Brain computed tomography angiography (Brain CTA) is the fastest and non-invasive way for diagnosing intracranial vessel currently. Because the cardiac function has not fully recovered, many patients will be placed on extracorporeal cardiopulmonary support system after cardiac surgery in order to support the cardiopulmonary circulation which is known as the extracorporeal membrane oxygenation (ECMO). Some patients with ECMO are suspected to have cerebral vascular lesions due to clinical features; therefore, a brain CTA was arranged. The report is based on the case of a 64-year-old male who suffered from coronary artery disease and received coronary artery bypass graft (CABG). After the surgery, the patient was placed on peripheral veno-arterial (VA) ECMO. While at the intensive care unit, he suffered from General Tonic-Clonic seizure (GTC), so a brain CTA was arranged. The purpose of this report is to show that the changes of hemodynamics in VA ECMO and the contrast medium will cause a filling defect in the right side of cerebral vessels. The clinical judgment and technical adjustment will optimize the final result of images and assist physicians in interpreting them.
延伸閱讀
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