Diagnostic Value and Post-operative Evaluation of MRA and CTA in Vascular Lesions of Low Extremity Caused by Crush Injury after Earthquake_West China Medical Journal

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Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;

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Keywords：

地震傷; 下肢血管; 磁共振血管造影,計算機斷層掃描血管成像

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目的:探討磁共振血管造影(MRA)以及計算機斷層掃描血管成像(CTA)對地震擠壓傷下肢血管病變的臨床價值。方法:對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例患者進行雙下肢MRA檢查,并對嚴重擠壓傷及下肢毀損,并行截肢的另三名患者進行術后CTA檢查。對MRA圖象雙下肢動脈進行回顧性分析,總結MRA征象,同時總結截肢術后患者CTA表現及臨床價值,并評價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。結果:3例未行截肢患者MRA雙下肢主要動脈未見確切狹窄及閉塞征象,管腔內未見充盈缺損影。3例已行截肢患者可見殘余肢體的明顯腫脹,雙側髂血管以及部分截斷肢體遠端血管內見止血彈簧鋼圈影像,部分截斷肢體遠端動脈分支變細。截斷血管未見再通,周圍無滲血改變。結論:MRA、CTA能直觀顯示雙下肢動脈損傷及術后情況,在臨床應用中各有優勢和局限性。對二者的合理選擇能為臨床診治提供有利信息。

Citation： LI Zhengyan,ZOU Ling,SONG Bin,et al. Diagnostic Value and Post-operative Evaluation of MRA and CTA in Vascular Lesions of Low Extremity Caused by Crush Injury after Earthquake. West China Medical Journal, 2009, 24(3): 575-578. doi: Copy

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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. LANGE RH.Limb reconstruction versus amputation decision making in massive lower extremity trauma[M].Clin Orthop Relat Res,1989:92-9..
4. 戴力揚.嚴重下肢創傷截肢手術指征的選擇[J].中華外科雜志,1998,36(5):284-286..
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. 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. 王佩芬,周康榮,陳祖望,等.下肢動脈慢性閉塞癥的MRA診斷[J].中華放射學雜志,1997,31(6):396-399..
8. 陳振松,孟志華,楊昂,等.三維增強MRA在外傷性下肢血管損傷的應用價值[J].實用醫技雜志,2005,12(10):2852-2854..
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. 仲海,徐卓東,柳澄,趙曉紅.64層螺旋CT血管成像對下肢動脈系統疾病的應用價值[J].醫學影像學雜志,2005,15(11):988-991.

West China Medical Journal

Diagnostic Value and Post-operative Evaluation of MRA and CTA in Vascular Lesions of Low Extremity Caused by Crush Injury after Earthquake

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