DSA在缺血性脑血管病诊治中的应用

Application of DSA in ischemic cerebrovascular disease

目的:探讨DSA在缺血性脑血管病诊断和血管内介入治疗中的应用。方法:通过对234例缺血性脑血管患者的全脑血管造影图像分析,得出病变血管的最佳投照角度。结果:基底动脉狭窄病变血管的最佳投照角度为向足倾斜28o±5o;椎动脉颅内段狭窄病变血管的最佳投照角度为右前斜或左前斜25o±3o;右椎动脉起始段狭窄病变血管的最佳投照角度为左前斜20o±5o并向头侧倾斜15o±5o;左椎动脉起始段狭窄病变血管的最佳投照角度为右前斜20o±5o;右侧锁骨下动脉起始段狭窄病变血管的最佳投照角度为左前斜50o±6o并向足侧倾斜20o±7o;左侧锁骨下动脉狭窄病变血管的最佳投照角度为左前斜50o±6o;大脑中动脉M1段近端狭窄病变血管的最佳投照角度为右前斜或左前斜15o±5o。结论:熟练操作机器,掌握机器的性能和技巧,正确应用最佳投照角度,有助于缺血性脑血管病的诊断和治疗。

Objective： To investigate the application of DSA in diagnosis and interventional therapy of ischemic cerebrovascular disease. Methods： The images of digital subtraction angiography in 234 cases of ischemic cerebrovascular disease were analyzed to find the best irradiating angle of blood vessels. Results： Through using equipment proficiently to master the skill of control equipment, use the best irradiate angle, it could make for the diagnosis and interventional therapy of ischemic cerebrovascular disease. The best irradiating angle of blood vessel of the basilar artery narrowing was 28o±5o to foot oblique. The best irradiating angle of blood vessel of arteria vertebralis trachelo-inner segment was 25o±3o to right anterior oblique or left anterior oblique. The best irradiating angle of blood vessel of right vertebral artery was 20o±5o to left anterior oblique and 15o±5o to head oblique. The best irradiating angle of blood vessel of left vertebral artery was 20o±5o to right anterior oblique. The best irradiating angle of blood vessel of right subclavian artery was 50o±6o to left anterior oblique and 20o±7o to foot oblique. The best irradiating angle of blood vessel of left subclavian artery was 50o±6o to right anterior oblique. The best irradiating angle of blood vessel of M1 arteria cerebri media was 15o±5o to right anterior oblique or left anterior oblique. Conclusion： Skillful manipulation of the equipment and correct use of irradiating angle are helpful for diagnosis and treatment of ischemic cerebrovascular disease.