Miyazono N, Inoue H, Ueno K, Nishida H, Kanetsuki I, Miyake S, Nakajo M
Department of Radiology, Faculty of Medicine, Kagoshima University.
Nihon Igaku Hoshasen Gakkai Zasshi. 1995 Apr;55(5):289-95.
Carbon dioxide (CO2) intraarterial subtraction angiography (IADSA) was performed in 31 patients with various hepatobiliary diseases. The injection sites of CO2 were proper hepatic artery (10/31; group A), segmental hepatic artery (18/31; group B), and peripheral inferior phrenic artery (3/31; group C), respectively. In group A, only the third order branches of the portal venous system were visualized anterogradely in 8 of 10 patients. In group B, the microcatheter was placed coaxially through a 5 French guiding catheter at the main arterial supply of the tumor in 7 patients and at the peripheral segmental branch of the hepatic artery in 11 patients. The portal venous system was visualized retrogradely in all of the patients regardless of the injection site. The injected CO2 may flow back into the portal vein through the anastomosis known as the peribiliary or periportal plexus. In group C, not only the portal vein but also the pulmonary artery or pericardial vein were visualized by this method. CO2-IADSA was useful to image the minute communications between the various vessels, which have been not hitherto visualized by iodinated contrast medium.
对31例患有各种肝胆疾病的患者进行了二氧化碳（CO₂）动脉内减影血管造影（IADSA）。CO₂的注射部位分别为肝固有动脉（10/31；A组）、肝段动脉（18/31；B组）和膈下动脉外周支（3/31；C组）。在A组中，10例患者中有8例门静脉系统的三级分支仅呈顺行显影。在B组中，7例患者将微导管通过5F引导导管同轴放置在肿瘤的主要动脉供血处，11例患者放置在肝动脉的外周段分支处。无论注射部位如何，所有患者的门静脉系统均呈逆行显影。注入的CO₂可能通过称为胆管周围或门静脉周围丛的吻合支回流到门静脉。在C组中，通过这种方法不仅可以观察到门静脉，还可以观察到肺动脉或心包静脉。CO₂ - IADSA对于显示各种血管之间微小的交通支很有用，这些交通支迄今尚未通过碘化造影剂显影。
