Application of MSCT in interventional embolization of iatrogenic hemorrhage in urinary system
10.13929/j.1672-8475.201805030
- Author:
Wenji LIN
1
Author Information
1. Department of Radiology, Quanzhou First Hosptial of Fujian Medical University
- Publication Type:Journal Article
- Keywords:
Hemorrhage;
Iatrogenic;
Interventional therapy;
Tomography, X-ray computed
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(2):88-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To observe the value of preoperative enhanced MSCT before interventional treatment of iatrogenic hemorrhage in different positions of urinary system. Methods: Data of 27 patients underwent interventional therapy for iatrogenic bleeding in different positions of the urinary system were retrospectively analyzed. The detection rate of bleeding responsible vessels were compared between preoperative enhanced MSCT and the first time intraoperative DSA. CT and DSA findings were also studied. Results: Bleeding responsible vessels were identified in 26 patients (26/27, 96.30%) with preoperative enhanced MSCT, mainly manifested as arterial plaque contrast agent extravasation, contrast agent concentration and early developing of renal vein. Sign of arteriovenous fistula detected with the first time intraoperative DSA was observed in 1 patient without a clearly responsible vessel for bleeding using preoperative enhanced MSCT. In 24 patients (24/27, 88.89%), the responsible vessels for bleeding were identified with the first time intraoperative DSA, mainly manifested as contrast agent extravasation, pseudoaneurysm and renal arteriovenous fistula. Responsible vessels for bleeding were not detected with the first time intraoperative DSA in 3 patients who had characteristic findings of preoperative enhanced MSCT, including contrast agent extravasation in 2 patients and early developing of renal vein in 1 patient. With the reference of preoperative MSCT manifestations, bleeding responsible vessels were clearly detected with the second time DSA during operation. There was no significant difference of the detection rate of bleeding responsible vessel between preoperative enhanced MSCT and the first time intraoperative DSA (χ2=1.08, P=0.29). Conclusion: Bleeding responsible vessels of iatrogenic hemorrhage in different positions of urinary system can be detected accurately with preoperative enhanced MSCT. Enhanced MSCT images can also be used as the references for patients without clearly responsible vessel for bleeding using the first time intraoperative DSA of interventional therapy, so as to embolize the responsible vessel rapidly and effectively.