腹盆腔动静脉瘘的MSCT诊断

MSCT Diagnosis of Abdominal and Pelvic Arteriovenous Fistula

目的探讨MSCT诊断腹盆腔动静脉瘘的应用价值。方法回顾性分析临床资料完整的5例腹盆腔动静脉瘘的MSCT表现。MSCT扫描采用平扫加动静脉双期扫描,动脉期35s,静脉期65s。在工作站作血管MIP、MPR、VR和CPR后处理。结果肠系膜上动脉-门静脉瘘1例,肠系膜上动脉-下腔静脉瘘1例,左右侧髂内动脉假性动脉瘤并下腔静脉瘘各式各1例,左侧髂内动静脉瘘1例。5例病例均为CT检查首次发现并确诊,MSCT均能清楚显示供应动脉、回流静脉。3例盆腔动静脉瘘动脉破口直径分别为0.7cm、1.4cm和1.5cm。2例并发假性动脉瘤的瘤腔大小分别为7.1cm×8.1cm×11.4cm和3.1cm×3.5cm×3.6cm。结论 MSCT能清楚显示动静脉瘘时动静脉瘘口、瘤腔和相关血管情况,为动静脉瘘有效的影像检查方法。

Objective To explore the application value of multi-dice CT in diagnosing abdominal and pelvic arteriovenous fistula（AVF）. Met/lode The clinic data and MSCT findings of 5 cases with abdominal and pelvic AVF were analyzed retrospectively. The plain scan, arterial phase and venous phase （35 and 65 seconds after the injection of contrast medium） were acquired in all the cases. MIP, MPR, VR and CPR reconstruction of the vessels were performed at workstation. Results Of the 5 cases, there were one superior mesenteric arterial-portal vein fistula, one superior mesenteric artery-inferior vena cava fistula, one leti and right internal iliac artery-inferior vena cava fistula accompanied pseudoaneurysm respectively, and one left internal iliac arteriovenous fistula. All of the five cases were showed on first CT examination and confirmed by DSA. The supply arteries and the draining veins showed clearly in all the cases. The crevasse diameters of three cases of pelvic AVF were 0.7cm, 1.4cm and 1.5cm respectively. The sizes of the taro pseudoaneurysms which accompanied by AVF were 7.1cm × 8.1cm × 11.4cm and 3.1cm × 3.5cm × 3.6cm respectively. Conclusion It demonstrated that MSCT can show the crevasse, lumen and associated vessels of AVF clearly, that was an effective imaging method for diagnosing AVF.