Kerns S R, Hawkins I F
Department of Radiology, University of Florida, Gainesville 32610.
AJR Am J Roentgenol. 1995 Mar;164(3):735-41. doi: 10.2214/ajr.164.3.7863904.
Although several noninvasive techniques now exist for vascular imaging, including MR imaging, three-dimensional CT, and color-flow and duplex sonography, the gold standard to which these techniques are compared remains catheter angiography. Cut-film and digital subtraction angiography (DSA) using iodinated contrast material are the standard methods by which vascular imaging is performed. However, despite the development of low-osmolar contrast agents, premedication regimens, and careful patient selection, adverse reactions to contrast material, including idiosyncratic reactions and contrast-induced nephropathy, continue to occur in a small number of patients [1-3]. Carbon dioxide (CO2) was developed as an alternative to iodinated contrast material to avoid these problems [4]. Once the behavior of intravascular gas, the methods of safe delivery, and the principles of successful imaging are understood, the use of CO2 as an intravascular contrast agent during DSA allows accurate imaging with little risk. Recent advances in delivery systems, postprocessing capabilities, and its extension to new vascular interventional procedures have greatly expanded the usefulness of CO2 angiography in both diagnostic and interventional vascular radiology.
尽管目前存在多种用于血管成像的非侵入性技术，包括磁共振成像（MR成像）、三维CT以及彩色血流和双功超声检查，但用于与这些技术进行比较的金标准仍是导管血管造影。使用碘化造影剂的平片血管造影和数字减影血管造影（DSA）是进行血管成像的标准方法。然而，尽管低渗造影剂、预处理方案有所发展，且患者选择也很谨慎，但仍有少数患者会发生造影剂不良反应，包括特异反应和造影剂肾病[1-3]。二氧化碳（CO2）作为碘化造影剂的替代品被研发出来以避免这些问题[4]。一旦了解血管内气体的行为、安全输送方法以及成功成像的原理，在DSA期间使用CO2作为血管内造影剂可实现精确成像且风险极小。输送系统、后处理能力方面的最新进展以及其在新的血管介入手术中的应用极大地扩展了CO2血管造影在诊断性和介入性血管放射学中的用途。
