CT血管造影评估动静脉内瘘

摘要

目的 利用CT血管重建评估血液透析患者的动静脉内瘘.方法 选择慢性肾脏病5期维持性血液透析患者69例,采用256排螺旋CT,自非内瘘侧肘前静脉或颈外静脉以3 ml/s的速度注入浓度为300 mgI/ml的碘海醇100 ml,延时25～30 s开始扫描,完成CT血管重建,共进行86次CT血管重建.结果 所有病例动静脉内瘘血管均得到良好显示.8例次未发现异常,78例次发现异常,其中内瘘吻合口狭窄25例次,内瘘引流静脉狭窄42例次,内瘘吻合口和引流静脉同时狭窄10例次,动脉狭窄1例次.结论 CT血管重建可以安全有效地显示动静脉内瘘,有助于发现内瘘的形态异常并指导治疗.%Objective To examine arteriovenous fistula (AVF) for hemodialysis by CT angiography(CTA).Methods Sixty-nine patients with chronic renal failure were enrolled in this study. CTA was undertaken by 256-slice scanner. A total of 100 ml of iohexol was administered at a rate of 3 ml/s into a vein of contralateral limb or external jugular vein.Imaging commenced after a delay of 25-30 s and 86 times imaging were performed. Results The AVF were clearly displayed on CTA. Eight CTA were normal. Twenty-five CTA showed stoma stenosis. Forty-two CTA showed venous stenosis. Ten CTA showed stoma stenosis combined with venous stenosis. Only one CTA showed artery stenosis. Conclusions CTA can reveal the AVF safely and correctly,which might help to find abnormality of AVF and direct treatment .