- 期刊
周邊血管快速注射顯影劑之頭頸部動脈磁振血管攝影錯失、陷阱與無法避免等因素－病例探討
Peripheral Vascular Rapid Injection Contrast Agents of the Carotid Artery Magnetic Resonance Angiography: Failure, Pitfalls, and Inevitably Other Factors - Case Report
摘要
本研究針對兩側上肢快速注射顯影劑之磁振血管攝影(Magnetic Resonance Angiography, MRA)血管顯影品質有所差異為研究目的。研究方法以回溯方式自2015 年1 月至2015 年12 月蒐集，共計500 例個案。個案主要針對經周邊靜脈快速注射顯影劑之頭頸部動脈磁振血管攝影檢查，比較左上肢與右上肢周邊靜脈注射之成像品質。注射顯影劑的方式分別為左側上肢175 例與右側上肢325 例，顯影不佳的個案有其共通點是出現靜脈逆流，嚴重的靜脈逆流顯影劑會循環至整個腦部導致難以診斷。此研究以比例變項Z 檢定進行考驗 p = 0.0096 ＜ 0.05，有足夠數據證明拒絕虛無假設，檢定說明經右側上肢注射顯影劑影像顯影表現優於左側上肢的顯影表現。本研究結果顯示磁振血管攝影經由左側上肢靜脈注射顯影劑失敗率較為右側高，且重覆性磁振血管攝影的檢查對於腎功能不良與過敏體質的受檢者可能會造成潛在危險，當右側上肢沒有禁止治療與注射顯影劑的前提下，最好的方式就是經右側上肢注射顯影劑執行腦部磁振血管攝影檢查。
並列摘要
The purpose of study is to explore the difference of Magnetic Resonance Angiography (MRA) imaging quality affected by rapid injection on both sides upper limb. A total of 500 cases were collected from January 2015 to December 2015. The MRA imaging quality of the head and neck arteries rapid injected by the left and right upper limbs and the right upper limb was compared. Injection of the developer were the left upper limb 175 cases and the right upper limb 325 cases, poorly image quality cases have a common point of venous countercurrent. Severe venous reflux will lead to difficult to diagnose. There is a significant difference between this study groups by proportional variable Z test (p = 0.0096 ＜0.05), and the hypothesis was rejected. The results showed that the imaging quality of rapid injecting via right upper limb was better than that via the left upper limb. The results of this study shows that magnetic resonance angiography rapid injected via the right side upper limb have lower failure rate, and that the examination of repetitive magnetic vasoconstriction may be potentially dangerous for subjects with renal dysfunction and allergies. Therefore, under the premise of the right side of the upper limb is not prohibited, the best way is the right side of the upper limb injection of the implementation of the brain magnetic imaging angiography.
延伸閱讀
- 鄧木火、張遵、郭萬祐、凌憬峯、張政彥、張晉民、楊建芳（1989）。頭頸部動脈硬化之診斷－主動脈注射數位化去贅影血管攝影與選擇性常規頸動脈攝影之比較。中華放射線醫學雜誌，14(1)，1-7。https://www.airitilibrary.com/Article/Detail?DocID=10188940-198903-14-1-1-7-a
- 康誠麟、王瑞祝、張力允、陳懷哲、陳文凱、廖宗義、阮國榮（2013）。利用影像導引放射治療評估具有侵入管路的頭頸部患者擺位準確性。中華放射線技術學雜誌，37(3)，133-138。https://www.airitilibrary.com/Article/Detail?DocID=16849418-201309-201309250005-201309250005-133-138
- 黃科庭、謝金宏、杜俊元、范揚凱、黃武達（2009）。頭頸部電腦斷層腦血管攝影減像技術之臨床應用。台灣應用輻射與同位素雜誌，5(3)，735-742。https://doi.org/10.29832/TJARI.200909.0006
- Hsu, L. S., Weng, H. H., Liao, Y. S., Yang, B. Y., Tsai, Y. H., & Hsu, S. L. (2008). 在頭頸部出血的病人進行血管攝影：使用休克指數與對比劑滲漏建立關聯性. 中華放射線醫學雜誌, 33(2), 57-63. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200806-33-2-57-63-a
- Lee, Y. H., & Yeh, S. J. (2007). Correlation of Common Carotid Artery Intima Media Thickness, Intracranial Arterial Stenosis and Post-stroke Cognitive Impairment. Acta Neurologica Taiwanica, 16(4), 207-213. https://doi.org/10.29819/ANT.200712.0003