肾动脉造影术

定义

肾动脉造影术 is a special x-ray of the blood vessels of the kidneys.

选择的名字

Renal angiogram; Angiography - kidney; Renal angiography; 肾动脉狭窄 - arteriography

如何执行测试

This test is done in the hospital or outpatient office. 你将躺在x光台上.

Health care providers often use an artery near the groin for the test. Occasionally, the provider may use an artery in the wrist.

您的供应商将:

• 清洁和剃须该区域.
• 在这个部位涂上麻药.
• 把针插进动脉.
• Pass a thin wire through the needle into the artery.
• 把针取出来.
• Insert a long, narrow, flexible tube called a catheter in its place.

The doctor directs the catheter into correct position using x-ray images of the body. An instrument called fluoroscope sends the images to a TV monitor, which the provider can see.

The catheter is pushed ahead over the wire into the aorta (main blood vessel from the heart). 然后进入肾动脉. The test uses a special dye (called contrast) to help the arteries show on the x-ray. The blood vessels of the kidneys are not seen with ordinary x-rays. The dye flows through the catheter into the kidney artery.

X-ray images are taken as the dye moves through the blood vessels. Saline (sterile salt water) containing a blood thinner may also be sent through the catheter to keep blood in the area from clotting.

在拍完x光片后取出导管. A closure device is placed in the groin or pressure is applied to the area to stop the bleeding. You may be asked to keep your leg straight for 4 to 6 hours after the procedure.

如何准备考试

如果:

• 你怀孕了
• 你有出血的问题吗
• You currently take blood thinners, including daily aspirin
• 你有过吗? 过敏反应, especially those related to x-ray contrast material or iodine substances
• You have ever been diagnosed with kidney failure or poorly functioning kidneys

你必须签一份同意书. DO NOT eat or drink anything for 6 to 8 hours before the test. You will be given a hospital gown to wear and asked to remove all jewelry. You may be given a pain pill (sedative) before the procedure or IV sedatives during the procedure.

考试的感觉如何

你要平躺在x光台上. There is usually a cushion, but it is not as comfortable as a bed. You may feel a sting when the anesthesia medicine is given. You may feel some pressure and discomfort as the catheter is positioned.

Some people feel a warm sensation when the dye is injected, but most people cannot feel it. 你感觉不到体内的导管.

There may be slight tenderness and bruising at the site of the injection after the test.

为什么要进行测试

肾动脉造影术 is often needed to help decide on the best treatment after other tests are done first. 这些包括 双超声, CT abdomen, CT angiogram, MRI abdomen, or MRI angiogram. 这些测试可能会显示以下问题.

• 动脉的异常扩张，称为动脉扩张 动脉瘤
• 静脉和动脉之间的异常连接(动静脉瘘)
• 血凝块阻塞了供应肾脏的动脉
• Unexplained high blood pressure thought to be due to 肾脏血管狭窄肾脏血管狭窄
• 涉及肾脏的良性肿瘤和癌症
• 肾出血

This test may be used to examine donors and recipients before a kidney transplant.

正常的结果

结果可能会有所不同. Talk to your doctor about the meaning of your specific test results.

异常结果意味着什么

肾血管造影可显示肿瘤的存在, narrowing of the artery or 动脉瘤s (widening of the vein or artery), 血凝块, 动静脉瘘, 或者肾脏出血.

The test may also be done with the following conditions:

• 血凝块堵塞动脉
• 肾动脉狭窄
• 肾细胞癌
• Angiomyolipomas (noncancerous tumors of the kidney)

Some of these problems can be treated with techniques done at the same time the arteriogram is performed.

• Angioplasty is a procedure to open a narrowed or blocked blood vessels that supply blood to your kidneys.
• A stent is a small, metal mesh tube that keeps the artery open. 它可以用来保持狭窄的动脉畅通.
• Cancers and noncancerous tumors can be treated using a process called embolization. This involves using substances that block blood flow in order to kill or shrink the tumor. Sometimes, this is performed in combination with surgery.
• 出血也可以用栓塞治疗.
  

风险

这个过程通常是安全的. 可能会有一些风险，例如:

• 对染料(造影剂)过敏反应
• 动脉损伤
• Damage to the artery or artery wall, which can lead to 血凝块
• Kidney damage from damage to the artery or from the dye

有很低的 辐射暴露. Pregnant women and children are more sensitive to the risks related to x-rays.

注意事项

The test should NOT be done if you are pregnant or have severe bleeding problems.

磁共振血管造影 (MRA)或CT血管造影(CTA)可以代替. MRA and CTA are noninvasive and can provide similar imaging of the kidney arteries, 虽然它们不能用于治疗.

参考文献

Azarbal AF, Mclafferty RB. 动脉造影术. 见:Sidawy AN, Perler BA编. Rutherford's Vascular Surgery and Endovascular Therapy. 9日艾德. Philadelphia, PA: Elsevier; 2019:chap 25.

Duddalwar VA, Jadvar H, Palmer SL. 诊断性肾显像. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. 布伦纳和雷克特的肾. 11日艾德. Philadelphia, PA: Elsevier; 2020:chap 25.

文本或SC. 肾血管性高血压和缺血性肾病. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. 布伦纳和雷克特的肾. 11日艾德. Philadelphia, PA: Elsevier; 2020:chap 47.