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Clinical application of stepping and rotational digital subtraction angiography for the arteries of lower extrimity<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
张学昕 孙立军 贺洪德 余厚军 尤志军 李敬邦
第四军医大学西京医院放射科，西安 710032
Xuexin Zhang ,Lijun Sun ,Hongde He ,
Houjun Yu ,Zhijun You ,Jingbang Li
Department of Radiology , Xijing Hospital, the Fourth military Medical University Xi＇an Shaanxi 710032
ABSTRACT
Objective：To evaluate the clinical feasibility of stepping and rotational digital subtraction angiography (DSA) for the arteries of the lower extrimity.
Methods：Stepping DSA of the lower extremity was made in 45 cases and rotational DSA was performed additionally in 9 of 45 cases via femoral artery by Seldinger technique .
Results：All Stepping DSAs of the lower extremity were performed successfully in 45 cases and dynamic images of stepping DSA were obtained. The stem artery 、branches 、runnig、distribution and abnormal shunts were clearly displayed. The diseased anatomic details and the origins and numbers of supplying arteries of lower extremity were determined accurately.
Conclusion：The stepping and rotational DSA are useful to display clearly anatomical details of arteries of lower extremity and helpful in reducing contrast agent and radiation doses.
Key Words：Digital subtraction angiography Stepping and rotational DSA Angiography of lower extrimity
下肢动脉血管造影技术是现代医学影像技术重要的组成部分。目前许多血管性疾病的诊断和治疗都要借助DSA血管造影来完成。下肢动脉步进DSA技术是目前血管造影中,观察下肢动脉血管重要的检查技术[1]。笔者对疑有下肢动脉血管病变的45例患者施行了下肢动脉步进DSA检查, 其中9例同时实施了旋转DSA检查并取得较好效果，现报告如下。
材料与方法
1.一般材料﹕45例下肢动脉步进DSA检查患者中，男性34例，女性11例，年龄在14～79岁之间，平均年龄53岁。
2.使用设备﹕使用PHILIPS V-5000数字减影系统，美国MARK V Plus型高压注射器，配用高压连接管（80cm-120cm）。
3.方法﹕采用Seldinger技术经股动脉插管，对45例下肢动脉病变患者行下肢动脉步进DSA检查。下肢动脉步进DSA检查均需先进行血管造影再采集蒙片，通过影像的后处理显示下肢动脉步进DSA的动态影像和血管造影影像。下肢动脉旋转DSA检查，首先确定旋转角度、旋转方向、旋转中心，设定高压注射器参数，造影剂选用欧乃派克（300mgI/ml），下肢动脉步进加旋转DSA检查影像采集12.5帧/s，造影中采用手动控制检查床的移动速度。 | 
