腹内脏器细针穿刺行CO2静脉造影的实验研究

目的探讨细针穿刺腹部脏器组织行CO2静脉造影的可行性和安全性。方法选择健康雌猪2头和雌犬2条，麻醉后，用25G细穿刺针直视下多点穿刺脾、肝、肾、胰腺、小肠和子宫组织。手推法注射CO2行数字减影静脉造影。结果细针穿刺CO2造影可显示脾-门静脉系统、肝静脉、门静脉、肾一下腔静脉、子宫-卵巢静脉，不能显示胰腺和小肠引流静脉。其中，以脾-门静脉系统显示最佳，其影像质量评定结果为A级、B级和C级分别为87．5％(7／8)、12．5％(1／8)和0％；其他依次为肝静脉A级、B级和C级分别为81．8％(9／11)、18．2％(2／11)和0％]、门静脉A级、B级和C级分别为77．8％(7／9)、22．2％(2／9)和0％]、肾-下腔静脉A级、B级和C级分别为38．5％(5／13)、61．5％(8／13)和0％]、子宫．卵巢静脉A级、B级和C级分别为0％、33．3％(2／6)和66．7％(4／6)]。术中未发现实验动物的重要生命体征发生改变。结论细针直接穿刺部分腹部脏器组织行CO2数字减影静脉造影是安全可行的。

Experimental study on venography with carbon dioxide by fine-needle direct-puncture of abdominal viscera

Objective To evaluate the feasibility and safety of CO_2 venography by fine-needle direct-puncture of abdominal viscera. Methods Two healthy female pigs and two healthy female dogs were used in this study. Multi-point punctures of abdominal viscera including liver, spleen, kidney, pancreas, walls of small intestines, and uterus with 25-gauge needle were performed for CO_2 venography in all animals. Diagnostic image quality of the angiographic images was assessed by 3 independent observers. Results Splenic-portal vein, hepatic vein, portal vein, renal vein and inferior vena cava, uterine vein and ovarian vein could be visualized by fine needle direct CO_2 injection into the related organic parenchyma, while draining vein of small intestines and pancreas could not be shown. Splenic-portal veins were revealed especially well with grade A of 87.5%(7/8), grade B of 12.5%(1/8), and grade C of 0%. The image quality of hepatic veins were 81.8%(9/11), 18.2%(2/11), and 0% for grade A, B, and C, respectively. The portal veins were 77.8%(7/9), 22.2%(2/9), and 0% for grade A, B, and C, respectively. The renal vein and inferior vena cava were 38.5%(5/13), 61.5%(8/13), and 0% for grade A, B, and C respectively. The uterine veins and ovarian veins were 0%, 33.3%(2/6), and 66.7%(4/6) for grade A, B, and C, respectively. During the CO_2 angiographic procedure, vital signs remained stable in all animals. Conclusion CO_2 venography with fine-needle direct-puncture of abdominal viscera, excluding small intestines and pancreas, is feasible and safe.