Özgen Ali, Sanioğlu Soner, Bingöl Uğur Anıl
Department of Radiology, Yeditepe University Hospital, İçerenköy mahallesi, Hastane yolu sokak, No: 102-104, 34752, Ataşehir, İstanbul, Turkey.
Department of Cardiovascular Surgery, Yeditepe University Hospital, İçerenköy mahallesi, Hastane yolu sokak, No: 102-104, 34752, Ataşehir, İstanbul, Turkey.
Cardiovasc Intervent Radiol. 2016 Aug;39(8):1165-9. doi: 10.1007/s00270-016-1358-6. Epub 2016 May 5.
To image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).
Three cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatinine levels were followed for possible CIN.
Intra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.
Intra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.
对于发生对比剂肾病（CIN）风险较高的患者，采用极低剂量动脉内造影剂通过CT血管造影对下肢动脉进行成像。
对3例患有长期糖尿病且有下肢动脉粥样硬化疾病体征的患者，经皮穿刺股总动脉，通过10厘米长的4F导管以0.1毫升/千克体重的造影剂经动脉内注射进行CT血管造影评估。由一名介入放射科医生和一名心血管外科医生对图像进行评估。还计算了下肢动脉的密度值。将2例患者的检查结果与为经皮血管重建术进行的数字减影血管造影图像进行比较。跟踪血肌酐水平以监测是否可能发生CIN。
所有患者的动脉内CT血管造影图像均被认为具有诊断价值，其中1例患者的图像质量最佳。动脉内CT血管造影术后无患者发生CIN，而1例患者在经皮介入术后发生了CIN。
对于发生CIN风险较高的特定患者，可进行下肢动脉内CT血管造影。我们有限的经验表明，低至0.1毫升/千克体重的造影剂可能会产生足够的诊断性成像。
