彩色多普勒血流成像技术在输尿管结石诊断中的应用

目的 探讨应用彩色多普勒血流成像(CDFI)技术提高输尿管结石的检出率.方法 对216例有肾绞痛患者进行二维超声检查,并采用CDFI观察、比较两侧输尿管喷尿情况.结果 211例患者确诊,漏诊5例;大部分患侧输尿管喷尿发生改变,主要表现为:喷尿消失19例,喷尿形态失常或频率减慢125例,喷尿无改变67例.结论 应用CDFI有利于提高输尿管结石的检出率,特别是输尿管中、下段结石及无肾积水者.     

彩色多普勒超声诊断输尿管结石的临床价值

目的：探讨彩色多普勒（CDFI）超声对输尿管结石的诊断价值。方法：回顾160例输尿管结石病例,经CDFI检测输尿管结石周边尿流变化及输尿管开口喷尿情况的变化,确定结石的存在。结果：上段结石78例,中段20例,下段62例,结石周边尿流出现五彩镶嵌彩色信号,且输尿管开口喷尿出现异常。结论：CDFI对输尿管结石诊断率高,重复性好,无痛 苦,可作为输尿管结石的首选检查方法。     

输尿管结石的彩色多普勒超声诊断

我院近两年来用彩色多普勒超声诊断仪观察输尿管开口喷尿特点,诊断输尿管结石41例,取得良好效果,现总结如下。1资料与方法本组病例均为我院门诊、住院病人,男28例,女13例,年龄18－62岁,平均41．2岁,所有病人均经静脉肾盂造影证实。使用美国惠普HP－1000彩色多普勒多功能超声诊断仪,探头频率3．SMHz。患者在膀眈中度充盈下,常规做双紧扫查,注意肾盂积水情况,输尿管有无扩张,能否显示结石,然后检查膀胱,用彩色多普勒观察双侧输尿管开口喷尿特点,检查时间为5－10min,用热敏打印机记录。2结果41例中二维超声显示患者中度肾孟…     

彩色多普勒观察膀胱喷尿现象在判断输尿管结石梗阻中的作用

本文利用彩色多普勒观察输尿管结石梗阻患者和正常人膀胱喷尿情况,以探讨彩色多普勒在判断膀胱输尿管结石梗阻中的作用。因尿液由输尿管入膀胱呈喷射状,有一定速度,彩色多普勒可以较清晰地观察尿液流动信号(以下简称尿流信号),在分析输尿管结石中有一定价值。 资料和方法 本文病例组38例,其中第一狭窄结石11例,第二狭窄结石5例,第三狭窄结石22例。男28例,女10例,年龄29～63岁,平均42.5岁。结石大小在0.4～2.2cm。对照组选择正常人30例,男26例,女22例,年龄27～61岁,平均44.5岁。病例组及对照组所有受试者肾功能均正常。     

正常成人输尿管开口喷尿多普勒现象的临床观测研究

目的：拓宽超声多普勒对泌尿系统疾病的诊断范围。方法：利用超声多普勒效应原理，对100例正常成人输尿管开口处喷尿活动进行多普勒现象观测。结果：彩色尿流呈间断、斜行喷射，频率3－10次／分，每次喷尿活动有2－3次加速现象。频谱表现：呈2－3峰波，流速21－40cm/s。结论：正常输尿管膀胱开口喷尿活动有规律和特征，根据其变化可提供泌尿系统疾病的诊断，扩大了超声多普勒对泌尿系统疾病尤其尿路梗阻性疾病的诊断范围。     

“彩色彗尾征”——输尿管结石的彩色多普勒超声特征

目的 :探讨彩色多普勒超声在输尿管结石中的特征性表现和应用价值。方法 :对 80例输尿管结石进行了彩色多普勒超声检查 ,并与 B超进行了对比分析。结果 :80例经彩色多普勒超声诊断的输尿管结石 ,上中下段结石的特征为可见结石后方的五彩尿流信号——“彩色彗尾征”,阳性率 97.5 % ,特异性 10 0 % ,而下段结石还具有输尿管喷尿受阻的特征而出现喷尿消失 ,两侧对比鲜明 ,经排石和手术得以证实。结论 :“彩色彗尾征”是彩色多普勒超声诊断输尿管结石的特异性征象 ,有确诊价值 ,输尿管喷尿两侧不对称可作为可疑输尿管结石的指标 ,弥补了B超诊断的不足。对有明显结石症状而高度怀疑泌尿系结石的患者 ,在 B超检查结果阴性时建议加做彩超检查 ,以免漏诊、误诊。     

彩色多普勒超声在诊断输尿管结石中的应用

目的 应用彩色多普勒超声提高输尿管结石的诊断水平.方法 对142例(144个结石)输尿管结石患者行二维超声和彩色多普勒超声检查,利用彩色多普勒显像协助观察输尿管走行;在可疑结石强回声后方寻找"彩色快闪伪像"以确定结石的存在;通过观察输尿管末端喷尿多普勒信号变化判断其有无梗阻.结果 144个结石位于输尿管第一狭窄及第三狭窄处共计75个,二维B超与彩超均检出74个,检出率相同;介于第一狭窄与第三狭窄之间的结石病灶共计69个,B超检出率为46%(32/69),应用彩色多普勒超声后检出率提高到77%(53/69),两者比较有显著性差异(P<0.01);超声未发现结石的17例患者,有11例显示输尿管末端喷尿次数减少、信号减弱,综合其超声及临床表现,提出疑似结石诊断,后经临床及其他影像学检查证实.结论 彩色多普勒超声能显著提高输尿管结石的诊断水平.     

腔内超声诊断盆段输尿管结石的价值

目的 探讨经阴道或直肠彩色多普勒超声对输尿管盆段结石诊断的价值.方法 用腔内彩色多普勒超声检查10例正常人双侧输尿管和21例输尿管盆段结石者的正常与患侧输尿管,显示输尿管及腔内结石;测量排尿期及排尿间隔期输尿管腔内径,记录输尿管口喷尿持续时间、间歇时间.结果 腔内超声对输尿管盆段结石的显示率100%.结石近段管腔内径较...     

输尿管囊肿的三维超声和彩色多普勒诊断

目的 :评估三维超声、彩色多普勒超声对输尿管囊肿的应用价值。方法 :用三维、彩色多普勒血流观察了 10例输尿管囊肿的立体形态及喷尿情况。结果 :三维超声立体感强 ,形态逼真 ,定位准确。彩色多普勒显像示喷尿的尿流束由囊肿内向膀胱喷射时较为明显 ,表现为细而色艳的彩色流束 ,而由输尿管向囊肿内喷射时流束则呈粗而色暗。结论 :三维超声和彩色多普勒超声能提高诊断输尿管囊肿的准确率 ,为临床提供更准确的诊疗信息     

输尿管囊肿患者超声表现与漏误诊分析

目的 分析输尿管囊肿超声检查漏诊、误诊原因.方法 回顾性分析53例输尿管囊肿患者的超声声像图,所有病例均经膀胱镜或手术病理证实.患者均适度充盈膀胱,行泌尿系常规超声检查,适当调节增益,多角度扫查,注意输尿管末端有无呈规律性膨大-缩小的囊状物,并观察囊状物的部位、大小、开口位置及形态变化规律.彩色多普勒血流显像实时观察囊肿开口处喷尿及输尿管向囊肿内喷尿情况.结果 本组53例输尿管囊肿患者中,左侧30例,右侧17例,双侧6例.合并囊肿内结石3例,伴重复肾3例,合并患侧肾发育不全2例,合并患侧孤立肾及巨输尿管1例,伴马蹄肾1例.伴肾功能损害21例,伴泌尿系感染9例.二维超声可直接显示出囊肿的部位、形态、大小及其变化,彩色多普勒血流显像可实时显示输尿管口喷尿征象.经过随访复查,超声首次检查漏诊4例,均在再次超声检查时发现病变.误诊4例,分别误诊为输尿管口脱垂、膀胱结石、输尿管结石、卵巢囊肿.结论 超声检查是输尿管囊肿首选检查方法.仪器调节不当、对本病的特殊超声征象认识不足是导致本病超声检查漏诊、误诊的主要原因.适当调节超声仪器,实时动态观察,充分认识本病,与相关疾病仔细鉴别,可以减少对本病的漏诊和误诊.     

正常中晚期妊娠输尿管射尿的彩色多普勒检查

目的：了解正常中晚期妊娠输尿管的尿动力学改变是否影响输尿管射尿,方法：彩色多普勒超声观察32例中晚期妊娠妇女和11例非妊娠对照者膀胱射尿情况,观察时间5分钟。结果：妊娠受试者平均射尿5．9次／分,左,右侧射尿频率平均差异百分比为49％,对照组平均射尿7．3次／分,左,右射尿频率差异百分比为13％, 试组与对照组之间射尿对称性方面具有显著性差异（P＜0．05）,32例妊娠受试者中有7例有单侧射尿缺乏,而对照者中无1例单侧射尿缺乏,结论：在妊娠中晚期,由于两侧输尿管射尿的不对称性,用彩色多普勒超声检测输尿管射尿诊断中晚期妊娠合并输尿管结石应慎应用 。     

Postoperative color Doppler flow ultrasonographic assessment of ureteral patency in gynecologic oncology patients

Our objective was to assess postoperative ureteral patency in gynecologic oncology patients with color Doppler flow ultrasonographic assessment of ureteral jets. Forty-five consecutive gynecologic oncology patients meeting inclusion criteria prospectively underwent postoperative transabdominal color Doppler flow ultrasonographic assessment of ureteral jets to establish patency; 48 consecutive women undergoing transabdominal ultrasonographic studies for benign gynecologic conditions served as a control group. Statistical analysis included two-tailed t-test, with P < 0.05 considered significant. Bilateral ureteral jets were successfully demonstrated by color Doppler flow ultrasonography in all study patients and control patients. The mean time required to visualize bilateral ureteral jets was significantly different between the study group and control group (mean, 5.8 min +/- 0.6 min versus 2.6 min +/- 0.2 min, respectively) (P < 0.05). We conclude that postoperative ureteral patency in gynecologic oncology patients can be easily demonstrated by transabdominal color Doppler flow ultrasonographic assessment of ureteric jets.     

针刺委中穴对排尿功能影响的超声观察

目的 利用多普勒超声评价针刺委中穴对排尿功能的影响。方法 对90名健康志愿者行彩色多普勒超声检查,观察针刺前及针刺后输尿管膀胱开口处喷尿频率及膀胱容积的变化情况;同时运用高频超声观察针刺得气时针尖所达的局部肌、筋膜结构。结果 运用彩色多普勒超声可直观显示针刺委中穴后输尿管膀胱开口处喷尿频率明显加快、膀胱容积增加,且高频超声能清晰显示得气时针尖所达局部肌、筋膜结构。结论 彩色多普勒高频超声可直观、准确、定量评价针刺委中穴对输尿管收缩的影响,并对针刺起效深度进行量化观察,对临床治疗具有重要指导意义。     

Transvaginal sonography in the assessment of distal ureteral calculi.

OBJECTIVES: To explore the morphological and functional findings of transvaginal sonography (TVS) in the diagnosis and management of distal ureteral calculi. METHODS: We retrospectively reviewed the imaging studies in seven cases of distal ureteral calculi (study group) and 20 cases of female volunteers without urinary tract infection (control group). All 27 patients had undergone TVS for assessment of the lower urinary tract. The variables measured on ultrasound included the presence or absence of distal ureteral calculi, the size and location of a calculus if present, the presence or absence of the ureter jet phenomenon, morphological changes of the ureteral papilla and adjoining tissue, and the height of the ureteral papilla, as well as vascular changes seen on Doppler imaging. RESULTS: In the controls, 80% of the ureteral papillae were triangular and 20% trapezoidal. The average (+/-SD) height of the ureteral papillae was 3.5 +/- 0.7 mm on the right and 3.6 +/- 0.9 mm on the left. There was no statistically significant difference between the heights of the right and left papillae (P = 0.619). In the study group, echogenic stones were identified in all seven patients and a hypoechogenic tubular structure connected to the involved papilla was identified in 6/7 patients. The average height of the involved papilla was 6.7 +/- 1.6 mm. Ureteric jets were visible in all patients in both the study and control groups. CONCLUSION: In patients with distal ureteral calculi, TVS provides a rapid, non-invasive and repeatable means of assessing the morphology and function of the distal ureter.     

Three-dimensional color Doppler: a new approach for quantitative assessment of mitral regurgitant jets.

Color Doppler echocardiography does not provide adequate information about the severity of mitral regurgitation in patients with eccentric mitral regurgitation. We have developed a new procedure for 3-dimensional (3D) color Doppler reconstruction and for segmentation of regurgitant jets. The volume of regurgitant jets was compared with jet area in 63 patients with mitral regurgitation. Mitral regurgitation was assessed by angiography, regurgitant fraction and volume by pulsed Doppler, JA by planimetry, and JV by 3-dimensional Doppler. Twenty-eight patients with central jets were compared with 35 patients with eccentric jets. In the patients with eccentric jets, JV showed significant correlations with regurgitant volume (r = 0.90; P <.01) and regurgitant fraction (r = 0.76; P < .01) and was able to separate groups with different degrees of mitral regurgitation (P <.01). Three-dimensional Doppler revealed origin, direction, and spatial spreading of complex jet geometry. JV, a new parameter of mitral regurgitation, was also capable of quantifying asymmetrical jets.     

Comparison of sonographic appearance of normal and postradiotherapy parotid glands: a preliminary study

This study was undertaken to evaluate and compare the grey-scale and Doppler sonographic features of postradiotherapy (RT) and normal parotid glands. A total of 10 patients with previous head and neck RT and with different degrees of xerostomia were included. Another 10 healthy subjects, who are age and gender-matched with the 10 patients, were also recruited. Grey-scale and Doppler ultrasound examinations of parotid glands were performed on both the patients and healthy subjects. The parotid glands were assessed for their size, echogenicity, echotexture, conspicuity of intraparotid ducts, blood flow velocity and vascular resistance. Results showed that post-RT parotid glands tended to be smaller than normal parotid glands with a significant difference in the transverse dimension (p < 0.05). Normal parotid glands appeared homogeneous, hyperechoic relative to the adjacent muscles and had marginally seen intraparotid ducts. Post-RT parotid glands were heterogeneous, isoechoic (50%) or hypoechoic (50%) relative to the adjacent muscles, and the intraparotid ducts were either marginally (50%) or obviously (50%) seen on ultrasound. The PSV, RI and PI of normal parotid glands were significantly higher than that of post-RT parotid glands (p < 0.05). However, the difference in EDV between normal and post-RT parotid glands was not significant (p > 0.05). In conclusion, ultrasound is useful in assessing parotid glands. To avoid image misinterpretation, post-RT changes in the sonographic appearance of parotid glands should be considered in examining patients with previous head and neck RT.     

输尿管下段梗阻性病变的腔内超声诊断

目的评价腔内超声结合彩色多普勒血流显像对输尿管下段梗阻性病变的诊断价值.方法对腹部超声可疑输尿管下段梗阻性病变的39例患者,应用腔内超声(经直肠或经阴道)结合彩色多普勒血流显像(CDFI)检查盆段输尿管.结果 39例患者中,明确诊断38例,其中输尿管结石33例;输尿管癌4例;输尿管手术后瘢痕狭窄1例;1例输尿管炎性狭窄,误诊为输尿管末端小囊肿.结论腔内超声结合CDFI为临床诊断输尿管下段梗阻性病变提供了一个无创,费用低廉而较经腹部超声效果更好的方法.     

Functional correlates of Doppler flow study of the female urethral vasculature.

OBJECTIVES: To examine the effect of individual patient factors (age, parity, body mass index, menstrual cycle, menopause, hormone replacement therapy, bladder neck position and urethral mobility) on the appearance of Doppler flow in urethral vessels, to investigate the association between the Doppler flow parameters and intrinsic urethral function, storage and voiding, and to explore differences in the urethral vasculature between subjects with and without urodynamic stress incontinence (USI). METHODS: Over a 4-year period we prospectively performed imaging studies in 355 women, including 244 who denied any lower urinary tract symptoms within the previous 3 months (Group A) and 111 who had had lower urinary tract symptoms (Group B). Studies included morphologic assessment and Doppler flow investigation of the lower urinary tract. Vascular flow velocity and vessel density in the urethral vasculature were measured. For women in Group B, multichannel urodynamic studies were also performed. RESULTS: The urethral vasculature has five main branches of vessels. Their appearance was not affected by the menstrual cycle or menopause except for those of the anterior vaginal vessel and anterior branch of the middle urethral vessel. Other than that of the posterior urethral vessel, in which there was a correlation with parity, the resistance index (RI) was not affected by individual patient factors. However, there was a correlation between the vascular index (VI) and individual factors such as age (r = -0.336, P = 0.002), body mass index (r = -0.287, P = 0.028), menopause (r = -0.402, P < 0.001), and hormone replacement therapy (r = 0.392, P = 0.027). Only the VI and RI of the posterior urethral vessel correlated significantly with the urethral pressure profile. In subjects with lower urinary tract symptoms, the appearance of the urethral vasculature on power Doppler imaging and the corresponding RI and VI values were not correlated with objective evidence of USI. CONCLUSION: Patient factors may affect specific Doppler flow parameters of the urethral vasculature, which are related to intrinsic resting urethral closure. There is no difference in the appearance of the urethral vasculature in subjects with or without USI.     

组织多普勒成像Tei指数测量对扩张型心肌病患者左室功能的评价

目的探讨组织多普勒成像(TDI)测量Tei指数评价扩张型心肌病(DCM)患者左室功能的价值。方法应用TDI获取25例DCM患者二尖瓣环间隔侧及左侧壁两点的运动频谱,测量等容舒张期(IRT)、等容收缩期(ICT)、射血时间(ET),并计算TDI-Tei指数,并与健康对照组及传统脉冲多普勒显像所测值进行比较。结果TDI所测DCM患者IRT、ICT显著延长,ET显著缩短,而TDI-Tei指数显著增大,TDI与传统脉冲多普勒显像两种方法所测IRT、ICT、ET及Tei指数分别呈直线相关,而两种方法所测二尖瓣环室间隔侧与左侧壁的Tei指数平均值相关性最高。结论TDI技术可用于测量DCM患者左室Tei指数,并与传统脉冲多普勒显像所测值相关性好。