Hollett M D, Marn C S, Ellis J H, Francis I R, Swartz R D
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109-0030.
AJR Am J Roentgenol. 1992 Nov;159(5):983-9. doi: 10.2214/ajr.159.5.1344976.
Patients on continuous ambulatory peritoneal dialysis are frequently referred for radiologic evaluation of complications related to the dialysis. We studied the value of CT peritoneography in evaluating these complications. CT peritoneography is a technique in which CT scans are obtained after dialysis fluid containing iodinated contrast material is infused into the peritoneal cavity through the dialysis catheter.
Sixty consecutive CT studies performed on 48 patients during a 5-year period were retrospectively analyzed. In each case (with two exceptions), the patient had clinical findings suggesting a complication related to peritoneal dialysis. Each study was reviewed for evidence of dialysate leaks, hernias, unopacified fluid collections, and peritoneal adhesions. The patients' medical records also were reviewed to determine the resulting therapy and outcome.
Twenty-nine dialysate leaks were detected on 25 examinations: 15 were along the catheter tunnel, 10 were at the site of a previous surgical incision, two were at a previous catheter site, and two were from an undetermined site (catheter tunnel suspected in both cases). Loculated, unopacified peritoneal fluid collections were present on seven examinations. Adhesions limiting dialysate distribution were shown on five examinations. Five abdominal wall hernias and two inguinal hernias were detected. Overall, at least one abnormality related to continuous ambulatory peritoneal dialysis was shown on 40 (67%) of 60 studies. In 29 (73%) of these cases, clinical management was changed.
CT peritoneography is useful for evaluating complications commonly encountered in patients on continuous ambulatory peritoneal dialysis.
持续非卧床腹膜透析患者常因透析相关并发症而接受影像学评估。我们研究了CT腹膜造影在评估这些并发症中的价值。CT腹膜造影是一种在通过透析导管将含碘造影剂的透析液注入腹腔后进行CT扫描的技术。
回顾性分析了在5年期间对48例患者进行的60次连续CT检查。在每例病例中（有两例除外），患者有提示与腹膜透析相关并发症的临床表现。对每项检查进行审查，以寻找透析液渗漏、疝、无造影剂的液体积聚和腹膜粘连的证据。还查阅了患者的病历，以确定最终的治疗方法和结果。
在25次检查中发现了29处透析液渗漏：15处沿导管隧道，10处在既往手术切口部位，2处在既往导管置入部位，2处来源不明（两例均怀疑来自导管隧道）。7次检查发现有局限性、无造影剂的腹膜液体积聚。5次检查显示有限制透析液分布的粘连。发现5例腹壁疝和2例腹股沟疝。总体而言，60项研究中有40项（67%）显示至少有一项与持续非卧床腹膜透析相关的异常。在其中29例（73%）病例中，临床治疗方案发生了改变。
CT腹膜造影有助于评估持续非卧床腹膜透析患者常见的并发症。
