• 四川大學(xué)華西醫(yī)院放射科,四川成都 610041;

目的:探討磁共振血管造影(MRA)以及計(jì)算機(jī)斷層掃描血管成像(CTA)對(duì)地震擠壓傷下肢血管病變的臨床價(jià)值。方法:對(duì)5·12汶川大地震中我院收治的已確診為地震擠壓傷致雙下肢橫紋肌溶解癥3例患者進(jìn)行雙下肢MRA檢查,并對(duì)嚴(yán)重?cái)D壓傷及下肢毀損,并行截肢的另三名患者進(jìn)行術(shù)后CTA檢查。對(duì)MRA圖象雙下肢動(dòng)脈進(jìn)行回顧性分析,總結(jié)MRA征象,同時(shí)總結(jié)截肢術(shù)后患者CTA表現(xiàn)及臨床價(jià)值,并評(píng)價(jià)二者檢查在擠壓傷所至橫紋肌溶解癥的臨床診治中的作用。結(jié)果:3例未行截肢患者M(jìn)RA雙下肢主要?jiǎng)用}未見確切狹窄及閉塞征象,管腔內(nèi)未見充盈缺損影。3例已行截肢患者可見殘余肢體的明顯腫脹,雙側(cè)髂血管以及部分截?cái)嘀w遠(yuǎn)端血管內(nèi)見止血彈簧鋼圈影像,部分截?cái)嘀w遠(yuǎn)端動(dòng)脈分支變細(xì)。截?cái)嘌芪匆娫偻?周圍無滲血改變。結(jié)論:MRA、CTA能直觀顯示雙下肢動(dòng)脈損傷及術(shù)后情況,在臨床應(yīng)用中各有優(yōu)勢(shì)和局限性。對(duì)二者的合理選擇能為臨床診治提供有利信息。

引用本文： 李崢艷,鄒翎,宋彬,李昌憲,黃子星,張翠萍. MRA及CTA對(duì)地震擠壓傷血管病變的診斷價(jià)值及術(shù)后評(píng)價(jià). 華西醫(yī)學(xué), 2009, 24(3): 575-578. doi: 復(fù)制

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8. 陳振松,孟志華,楊昂,等.三維增強(qiáng)MRA在外傷性下肢血管損傷的應(yīng)用價(jià)值[J].實(shí)用醫(yī)技雜志,2005,12(10):2852-2854..
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  1. 1. 張風(fēng)琴.下肢外傷性缺血截肢原因分析[J].中國(guó)骨傷,2001,14(9):567..
  2. 2. ASHWORTH EM,DALSING MC,GLOVER JL,et al.Lower extremity vascular trauma:a comprehensive,aggressive approach[J].J Trauma,1988,28:329-36..
  3. 3. LANGE RH.Limb reconstruction versus amputation decision making in massive lower extremity trauma[M].Clin Orthop Relat Res,1989:92-9..
  4. 4. 戴力揚(yáng).嚴(yán)重下肢創(chuàng)傷截肢手術(shù)指征的選擇[J].中華外科雜志,1998,36(5):284-286..
  5. 5. EREN N,OZGEN G,GUREL A,et al.Vascular injuries and amputation following limb fractures[J].Thorac Cardiovasc Surg,1990,38:48-50..
  6. 6. ONO H,NAKAGAWA Y,MIZUMOTO S,et al.Evaluation of vascular compliance and vasoconstrictive reactions in amputated hindlimbs of rats[J].J Orthop Res,1995,13:375-81..
  7. 7. 王佩芬,周康榮,陳祖望,等.下肢動(dòng)脈慢性閉塞癥的MRA診斷[J].中華放射學(xué)雜志,1997,31(6):396-399..
  8. 8. 陳振松,孟志華,楊昂,等.三維增強(qiáng)MRA在外傷性下肢血管損傷的應(yīng)用價(jià)值[J].實(shí)用醫(yī)技雜志,2005,12(10):2852-2854..
  9. 9. ADAMIS MK,LI W,WIELOPOLSKI PA,et al.Dynamic contrastenhanced subtraction MR angiography of the lower extremities:initial evaluation with a multisection twodimensional timeofflight sequence[J].Radiology,1995,196:689-95.
  10. 10. 仲海,徐卓東,柳澄,趙曉紅.64層螺旋CT血管成像對(duì)下肢動(dòng)脈系統(tǒng)疾病的應(yīng)用價(jià)值[J].醫(yī)學(xué)影像學(xué)雜志,2005,15(11):988-991.