数字减影血管造影在胃肠道疾病中的诊断价值

The Value of DSA in the Diagnosis of the Gastrointestinal Diseases

目的 评价DSA(DigitalSubtractionAngiography)对胃肠道疾病的诊断价值。 方法 回顾性分析均经手术病理证实的 40例胃肠道疾病的数字减影血管造影片 ,同时与钡餐、钡灌及内窥镜检查相对照。结果 血供丰富的病变有 :平滑肌肿瘤、腺癌、Crohn病与血管畸形 ,血管具有相应特征 ,结合钡餐、钡灌及内窥镜检查 ,临床诊断率较高。少血管病变有 :淋巴瘤、类癌及肠结核 ,缺乏明显的血管特征 ,介入诊断较难。平滑肌肿瘤血管呈“蜘蛛网”状 ,腺癌周血管增多、增粗 ,Crohn病病变肠管之间可见正常血管。血管畸形的血管增多、紊乱 ,钡灌及内窥镜检查多为阴性。结论 DSA对胃肠道疾病的诊断有一定帮助 ,尤其是对多血管肿瘤及血管畸形病变的诊断更有价值。

Objective To evaluate the value of DSA in the diagnosis of the gastrointestinal diseases. Methods The DSA of 40 cases of gastrointestinal diseases which pathologically confirmed were retrospectively studied and compared it with barium meal study , barium enema examination and endoscopy. Results In the 40 cases ,there are four kinds of diseases including leiomyoma, adnocarcinoma, Crohn′disease and vascular malformation are rich in vascularity, the vascular morphology of these diseases is special and is observed easily. Otherwise, lymphoma, carcinoid and tuberculosis which poor in vascularity are difficulty to diagnosis with DSA. The blood vessel of leiomyoma look like “spider network”, while it of adnocarcinoma is rich at edge of the mass. Normal blood vessels can be observed between abnormal site of Crohn’ disease. The vascular malformation is often dilated, proliferated of blood vessels and it has no sign with barium meal study and endoscopy frequntly. Conclusion DSA is help for diagnosis of the gastrointestinal diseases, especial in haper vascularity tumor and vascular malformation. [