Nilsson T, Carlsson A, Mâre K
Department of Radiology, Huddinge University Hospital, S-141 86, Huddinge, Sweden.
Eur Radiol. 1998;8(1):86-9. doi: 10.1007/s003300050344.
Pulmonary angiography (PA) for decades has been accepted as the gold standard for the diagnosis of pulmonary embolism (PE). Apprehensions that the procedure is expensive, invasive and thus associated with both fatal and non-fatal complications has more or less limited its use to patients presenting a non-diagnostic lung scan. However, this opinion originates from earlier studies. Increasing clinical demands for faster and safer diagnostics, together with improved techniques and safer contrast media, has led to an increased use of PA. In order to evaluate the complication rate, we retrospectively studied the case records of 707 consecutive patients who had undergone PA. During 1990-1994, 728 patients underwent PA at Danderyd and Huddinge University Hospital. Selective pulmonary angiography (cine or digital subtraction angiography), non-ionic, low-osmolar contrast media and modern pigtail catheters were used. Standard volumes were 40 ml at 2 s for each injection. Pressure measurements were made in 376 patients. A test injection was made in all patients in order to assess the flow rate. Experienced radiologists as well as residents performed the examinations and a total of 707 angiography protocols and clinical records were available for review in search of complications associated with the procedure. No deaths occurred. One major non-fatal complication (bleeding in the groin requiring surgery) was reported in one case. Moderate/minor complications (i. e. transient angina and cardiac failure, minor haematomas, urticaria) occurred in 10 patients (1.4 %). With modern contrast media and technique, pulmonary angiography is a safe procedure.
几十年来，肺血管造影术（PA）一直被公认为是诊断肺栓塞（PE）的金标准。人们担心该检查费用高昂、具有侵入性，因而会伴有致命和非致命并发症，这或多或少限制了其仅用于肺部扫描结果无法确诊的患者。然而，这种观点源于早期的研究。随着临床对更快、更安全诊断方法的需求不断增加，以及技术的改进和造影剂安全性的提高，PA的应用越来越广泛。为了评估并发症发生率，我们回顾性研究了707例连续接受PA检查患者的病例记录。1990年至1994年期间，丹德吕德和胡丁厄大学医院有728例患者接受了PA检查。采用了选择性肺血管造影术（电影或数字减影血管造影）、非离子型、低渗造影剂和现代猪尾导管。每次注射的标准剂量为40毫升，注射时间为2秒。对376例患者进行了压力测量。所有患者均进行了试注以评估流速。经验丰富的放射科医生和住院医生进行了检查，共有707份血管造影方案和临床记录可供审查，以查找与该检查相关的并发症。未发生死亡病例。报告了1例严重非致命并发症（腹股沟出血需要手术治疗）。10例患者（1.4%）出现中度/轻度并发症（即短暂性心绞痛和心力衰竭、轻度血肿、荨麻疹）。采用现代造影剂和技术，肺血管造影术是一种安全的检查方法。
