目的:探讨锥形束CT(CBCT)标记和融合图像引导技术在数字减影血管造影(DSA)图像中无血管外漏的肾脏破裂出血病例中应用的可行性。
方法:这是一项回顾性病例对照研究,包括43例因肾破裂出血和难以止血而接受经导管动脉栓塞的患者。将患者分为两组:CBCT组(在血管造影中没有观察到血管外漏的病例)和对照组(在血管造影中具有清晰可识别的目标血管的病例)。收集并分析基线特征和临床结果。
结果:结果显示,对照组和CBCT组在手术时间和术中输血方面没有统计学上的显着差异(P>.05)。该研究表明,与对照组相比,CBCT组的肉眼血尿改善率明显更高(P<0.05)。CBCT组显示血红蛋白增加较大,肌酐增加较小。对照组临床成功率为87.5%,CBCT组为90.9%(P>.05)。
结论:标记和融合图像引导技术在没有造影剂血管外漏的肾脏破裂出血病例中是有用的。技术是安全的,可行,而且有效,我们认为它优于纯粹的DSA指导。
结论:建议使用标记和融合图像引导技术来克服介入过程中无法检测到目标血管的挑战。该技术被认为是不劣于纯DSA引导的介入程序,其中目标血管是清楚可识别的。
OBJECTIVE: To explore the feasibility of using marking and fusion image-guided technique with cone-beam CT (CBCT) in cases of kidney ruptured
haemorrhage without extravascular leakage in digital subtraction angiography (DSA) images.
METHODS: This is a retrospective case-control study that included 43 patients who underwent transcatheter arterial embolization for kidney ruptured
haemorrhage and difficult haemostasis. The patients were divided into two groups: the CBCT group (cases without extravascular leakage observed in angiography) and the control group (cases with clearly identifiable target vessels in angiography). The baseline characteristics and clinical outcomes were collected and analysed.
RESULTS: The results showed no statistically significant differences in the duration of the procedure and intraoperative blood transfusion between the control and CBCT groups (P > .05). The study clarified that the CBCT group had a significantly higher rate of improvement of gross haematuria compared to the control group (P < .05). The CBCT group showed a greater increase in haemoglobin and a lesser increase in creatinine. The clinical success rates were 87.5% in the control group and 90.9% in the CBCT group (P > .05).
CONCLUSIONS: The marking and fusion image-guided technique is useful in cases of kidney ruptured
haemorrhage without extravascular leakage of contrast agent. The technique is safe, feasible, and effective, and we believe it is superior to purely DSA-guidance.
CONCLUSIONS: The use of the marking and fusion image-guided technique is recommended to overcome the challenge of undetectable target vessels during interventional procedures. This technique is considered as non-inferior to purely DSA-guided interventional procedures where the target vessels are clearly identifiable.