DSA与X线电影摄影对消化道出血敏感性的评价

Diagnostic Sensitivty of DSA and X-Ray's Cine Radiography for Digestive Tract Haemorrhage

目的：评价DSA与X线电影摄影对消化道出血检查的敏感性。材料与方法：50例病人，其中急性消化道出血24例，慢性消化道出血26例，全部病例均行腹腔动脉，肠系膜上、下动脉造影，必要时加做胃左动脉、胃十二指肠动脉、肝动脉造影。其中7例行栓塞治疗。栓塞剂为明胶海绵颗粒或不锈钢圈。结果：阳性发现38例（38／50），其中20例可见造影剂从血管内外溢，7例栓塞治疗后即刻止血。10例同时先后使用了DSA和Cine，7例栓塞病人选用DSA。DSA提示可疑出血或失败者均采用X线电影摄影。结论：DSA检查适用于易配合及栓塞治疗的病例．具有快速实时成像及分辨率高；X线电影适用于不易配合及显示细微病变者，不受病人运动及肠蠕动影响，图像清晰。

purposc: To evaluate the diagnostic sensitivty of digital Subrtaction angiography (DSA) and x -ray's cine radiography for digestive tract haemorrhage. Materials and Methods: The celiac, superior mesenteric and inferior mesenteric arteriography were performed with DSA and/or angiographic Cine radiog raphy in 50 patients. Which had acute or chronic gastrointestinal tract haemorrhage, meanwhile, the left gas tric, gastroduodenal and hepatic arteriography were additionally performed in a few patients. Seven of fifty patients underwent further arterial embolization using gelfoam powders of stainless steel coils as angioem bolic agents. Results: Haemorrhage sings were shown in 38 cases,that contrast medium outflow from arteries were seen in 20 of 38 cases. After embolization, all 7 patients stopped bleeding immediately. Ten patients were checked with both DSA and angiographic cine radiography, 7 patients treated by embolization only with DSA. All patients which were diagnosed as the doubtful haemorrhage by DSA or failed in the DSA examina tions were further checked with cine radiography' Conclusion: DSA examination that is advantage of fast,realtime imaging and high distinguish ability is fit for the cooperatine patients or the patients treated by arte rial emolization. Angiographic cine radiography examination that may not be influenced by patients motion and intestinal wriggle with clear images is fit for the cooperativeless patients and to display the small lesions.