支气管动脉多层螺旋CT血管成像在支气管动脉栓塞术中的应用价值

Clinical Application Value of Bronchial Arteries Multi-slice CT Angiography in Bronchial Artery Embolization for Massive Hemoptysis

目的评估支气管动脉多层螺旋CT血管成像(MSCTA)在支气管动脉栓塞术(BAE)前检查中的临床应用价值。方法选取医院2014年1月至2015年1月收治的大咯血并进行BAE的60例患者,将其随机分为A,B两组,各30例;A组术前行支气管动脉MSCTA和数字减影血管造影术(DSA)检查;B组术前未行支气管动脉MSCTA检查,比较两组手术时间及造影剂用量。结果 A组MSCTA与DSA共同检出支气管动脉95支,其中左右共干16支,迷走支气管动脉2支,MSCTA检出而DSA未检出支气管动脉1支,DSA检出而MSCTA未检出迷走支气管动脉1支。MSCTA与DSA血管检出符合率为98.95%。A组手术时间与造影剂用量均显著小于B组(P<0.05)。结论支气管动脉MSCTA作为BAE的术前检查能够减少对比剂用量,降低球管曝光时间,减少患者及施术者的辐射剂量。

Objective To explore the clinical value of bronchial artery multi-slice CT angiography as preoperative examination which provide information for bronchial artery embolization（BAE）. Methods Sixty patients who were hospitalized with massive hemoptysis and given BAE at the institution between January 1st 2014 and January 1st 2015 were selected and randomly divided into A and B group（30 cases each group）, group A were given MSCTA before BAE, group B performed BAE without MSCTA. Operation time and the amount of contrast agents were compared between two groups. Results In group A, 95 bronchial arteries including 16 common trunks and 2 aberrant bronchial arteries were clearly displayed in 30 cases. MSCTA found out the 94 bronchial arteries and missed only 1 artery; similarly, DSA found out 94 bronchial arteries and missed 1 artery. The concordance of MSCTA and DSA was 98.95%. There were significant differences between group A and group B in operation time（62.4±21.6 VS 137.77±38.9, P〈0.05） and the amount of contrast agents（90.67±19.4 VS 220.2±38.3, P〈0.05）. Conclusion Bronchial arteries MSCTA can shorten the exposure time and reduce the amount of contrast media in BAE, which showed significant clinical value for the BAE interventional therapy.