肝动脉CO_2-DSA和CT血管造影的动物实验研究

Carbon dioxide hepatic arterial DSA and CT angiography in swine model

目的评价肝动脉CO2DSA和CT血管造影(CO2CTA)在健康实验猪中的影像学表现。方法健康实验猪5头,全麻下经股动脉插管至肝固有动脉,先行碘对比剂肝动脉DSA(5ml/s,10ml),再手推CO230～50ml(5～8ml/s)行CO2DSA,然后再行CO2CTA。全麻下处死动物,选择性获取肝组织作病理学检查。分析比较碘对比剂DSA和CO2DSA和CO2CTA的图像表现特点,以及显示动静脉瘘的能力。结果碘对比剂肝动脉DSA未显示任何动静脉瘘,而CO2DSA显示3头猪在动脉晚期相气体进入门脉分支而使局部的段或叶门脉分支显影,并在CO2CTA上得到证实。门脉内气体在1～3min内吸收。CO2DSA和CO2CTA均未见CO2气体进入肝静脉。病理检查肝组织未见明显异常病理改变。结论(1)CO2DSA和CO2CTA显示健康实验猪肝动脉注射CO2后气体在动脉晚期相进入局部门脉分支,于1～3min内吸收消失。(2)健康实验猪CO2肝动脉灌注后CO2不会进入肝静脉。

Objective To evaluate the imaging findings of carbon dioxide hepatic arterial DSA and CT angiography in normal swine. Methods In general anaesthesia, hepatic arterial DSA was performed with 10 ml iodinated contrast medium (5 ml/s, 10 ml) in 5 normal swine, and then repeated hepatic arterial CO_2-DSA was performed with a total of 30-50 ml CO_2 injected by manually operated syringe at the velocity of 5-8 ml/s, followed by CO_2-CT angiography. All the swine were sacrificed after the procedure, the selective hepatic segments were removed, and pathological examination was carried out. The radiological features of hepatic arterial DSA with iodinated contrast medium and CO_2 and CT angiography with CO_2 were analyzed. The ability of showing the arterio-venous shunt was compared. Results Hepatic arterio-portal shunt was found in the advanced arterial phase of CO_2-DSA in three of five swine, which was furthermore demonstrated by CO_2-CT angiography, but iodinated contrast medium DSA showed no arterio-portal shunt in all swine. The gaseous CO_2 in portal vein was Absorbed within 1-3 minutes. No CO_2 shunted into the hepatic vein during CO_2-DSA and CO_2-CTA. Histology didn't reveal any abnormal changes caused by CO_2 shunt in the swine liver. Conclusion (1) Hepatic arterial CO_2-DSA and CO_2-CTA can reveal arterio-portal shunt that isn′t seen with iodinated contrast medium, the gaseous CO_2 in portal vein was Absorbed within 1-3 minutes. (2) The gaseous CO_2 can′t shunt into hepatic vein when the hepatic artery is perfused with CO_2 in normal swine.