超声评价单侧颈内动脉闭塞者颈部动脉血流动力学改变

目的应用超声评价单侧颈内动脉闭塞患者颈部其他动脉血流动力学改变。方法 50例单侧颈内动脉闭塞患者(闭塞组)及50例体检健康者(对照组),超声检查其颈总动脉、颈内动脉、颈外动脉及椎动脉的内径、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(MV)、搏动指数(PI)及阻力指数(RI),并计算颈总动脉与同侧颈外动脉的PSV比值、PI比值及RI比值。结果①闭塞组患侧颈总动脉的PSV、EDV及MV较健侧及对照组降低,PI和RI增加(P﹤0.05);患侧及健侧颈外动脉的PSV及MV较对照组增加(P﹤0.05);患侧椎动脉的内径、EDV、MV较健侧及对照组增加(P﹤0.05);健侧颈内动脉的PSV及MV较对照组增加(P﹤0.05)。②与健侧及对照组相比,患侧颈总动脉与颈外动脉的PSV比值、EDV比值及MV比值减小(P﹤0.01),PI比值和RI比值增大(P﹤0.05)。结论超声不仅可直接诊断颈内动脉闭塞,也可评价单侧颈内动脉闭塞后颈部其他动脉的血流动力学改变。     

早期妊娠黄体的超声诊断

目的了解早期妊娠黄体的二维声像特点及彩色多普勒血流特征。方法采用经阴道超声检测148例早期妊娠4～12周孕妇的卵巢,观察卵巢内黄体的二维声像及彩色多普勒血流改变,检测收缩期最大峰值流速(PVS)、阻力指数(RI)及搏动指数(PI)。结果148例早期妊娠孕妇卵巢中二维超声检出黄体130例,辅助彩色多普勒超声检出黄体146例,黄体囊平均直径2.3±0.77cm。黄体的二维声像分为3种类型:实性低回声型68例(46.6%)、厚壁囊肿型63例(43.2%),薄壁囊肿型15例(10.3%)。黄体血流分布特征为沿黄体囊壁边缘环状或半环状血流,环状血流占67.8%(99/146),不连续半环状血流占17.8%(26/146),仅7.5%(11/146)呈单支条状血流。黄体血流的多普勒频谱特征为中速低阻力的血流信号,收缩期最大峰值流速为0.307±0.154m/s,阻力指数(RI)0.475±0.069,搏动指数(PI)0.675±0.141,血流速度及血流阻力不随孕周增加而改变。结论早期妊娠经阴道彩超可准确识别卵巢中的妊娠黄体,妊娠黄体具有特征性超声表现。     

黄体囊肿误诊输卵管妊娠19例分析

目的：探讨卵巢黄体囊肿误诊为未破裂型输卵管妊娠的原因。方法：回顾性分析19例经腹超声疑诊为输卵管妊娠患者,应用经阴道超声结合彩色多普勒血流技术对卵巢黄体囊肿与未破裂型输卵管妊娠进行鉴别诊断。结果：15例患者腹部超声所发现卵巢旁囊实性包块为卵巢黄体囊肿,在对侧附件区发现输卵管妊娠包块。4例为子宫内孕,附件区包块为卵巢黄体囊肿。结论：经阴道超声结合彩色多普勒血流技术诊断未破裂型输卵管妊娠及卵巢黄体囊肿更准确,更有临床价值。     

彩色多普勒超声评估不同结局早孕妊娠黄体功能的价值

目的探讨经阴道彩色多普勒超声评估不同结局早孕妊娠黄体功能的临床价值。方法分析正常宫内早孕(A组,75例)及宫内早孕流产(B组,66例)的血清孕酮水平及妊娠黄体的经阴道彩色多普勒超声表现,包括妊娠黄体最大径线及血流动力学参数:收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)。结果A组血清孕酮水平高于B组(P<0.05)。两组妊娠黄体最大径线无显著差异(P>0.05);A组PSV、EDV均高于B组,RI低于B组(P<0.05)。结论正常宫内早孕者孕酮水平较宫内流产者高;经阴道彩色多普勒超声提示正常宫内早孕患者的妊娠黄体血供较宫内流产者好。     

早期不明位置妊娠经阴道彩色多普勒超声检测妊娠黄体临床价值探讨

目的探讨经阴道彩色多普勒超声检测妊娠黄体在诊断早期不明位置妊娠(PUL)中的应用价值。方法将146例PUL患者根据病理结果,分为早期输卵管妊娠(TP)组59例、宫内早孕(IUP)组45例及宫内早孕流产(IUPM)组42例,对比分析三组妊娠黄体大小、回声类型、血流分级及阻力指数(RI)的差异。结果早期TP组、IUP组及IUPM组妊娠黄体的平均径分别为(17.15±4.69)、(17.20±3.04)mm及(16.62±2.80)mm,三组妊娠黄体平均径比较差异无统计学意义(P=0.733)。三组妊娠黄体回声类型比较差异无统计学意义(χ2=3.578,P=0.748)。三组妊娠黄体血流分级比较差异有统计学意义(χ2=18.348,P=0.003)。早期TP组、IUP组及IUPM组妊娠黄体RI分别为(0.54±0.05)、(0.50±0.06)、(0.54±0.07)。早期TP组与IUP组、IUPM组与IUP组妊娠黄体RI比较差异有统计学意义(P=0.001、0.000)。早期TP组与IUPM组妊娠黄体RI比较差异无统计学意义(P=0.506)。结论经阴道彩色多普勒超声检测妊娠黄体血流丰富程度及RI值对判断PUL妊娠结局有一定的临床价值。     

彩色多普勒超声在异位妊娠诊断中的应用价值

目的应用彩色多普勒超声分析异位妊娠与子宫内妊娠区动脉血流参数的差异。方法回顾分析50例异位妊娠与50例宫内妊娠患者妊娠区动脉血流,应用彩色多普勒血流参数对比分析收缩期峰值流速(peak systolic velocity,PSV)与舒张期末血流最低流速(end diastolic velocity,EDV)、阻力指数(resistance index,RI)。异位妊娠均由手术病理证实,宫内妊娠均作人流术。结果异位妊娠患者其妊娠区与子宫腔内妊娠者的妊娠区均显示:流速曲线上阻力指数减低(RI<0.4),发现宫内妊娠收缩期未与舒张期峰值流速低于异位妊娠。结论宫内妊娠与宫外妊娠血流参数相比,PSV与EDV差异有统计学意义(P<0.05),但阻力指数差异无统计学意义(P>0.05)。利用两种妊娠区其彩色多普勒血流参数中RI相似,可作为诊断异位妊娠的一种新的辅助手段。     

双侧子宫动脉搏动指数差异诊断输卵管妊娠的临床研究

目的探讨双侧子宫动脉搏动差异在诊断输卵管妊娠(TP)中的临床应用价值,为临床诊断输卵管妊娠提供参考。方法选取2013年1月至2013年12月间入院诊治的70例输卵管妊娠的患者,作为实验组。根据TP包块与黄体位置、β-人绒毛膜促性腺激素(β-HCG)的水平分为A组(黄体与TP异侧)、B组(黄体与TP同侧,β-HCG≤800 m IU/ml)、C组(黄体与TP同侧,β-HCG800 m IU/ml)。选取同期入院检查的正常宫内早孕的70例孕妇作为对照组。观察并记录实验组与对照组双侧子宫动脉搏动指数(PI)的差异。结果实验组70例患者中A组7例(10.00%),B组26例(37.14%),C组37例(52.86%)。两组在平均值及S/D平均值方面比较差异无统计学意义(P0.05);实验组PI最小值0.99±0.37,明显低于对照组1.16±0.35,差异有统计学意义(P0.05)。对照组、A组、B组功能侧与非功能侧子宫动脉PI相比,差异无统计学意义(P0.05);C组功能侧子宫动脉PI为2.25±0.39,明显低于非功能侧的2.85±1.04,差异有统计学意义(P0.05)。两组间比较,功能侧C组明显低于对照组,A组明显高于C组,差异均有统计学意义(P0.05)。结论输卵管妊娠由于异位胚胎活力的影响,可造成功能侧与非功能侧子宫动脉搏动指数的差异,可为临床诊断输卵管妊娠提供一定的参考。     

妊娠晚期孕妇体位对彩色多普勒超声检测胎儿脐动脉和大脑中动脉血流影响

目的探讨妊娠晚期孕妇体位对彩色多普勒超声检测胎儿脐动脉和大脑中动脉血流影响及彩色多普勒超声检测预测胎儿宫内缺氧价值。方法应用彩色多普勒超声检测67例妊娠晚期孕妇仰卧位、左侧卧位及右侧卧位胎儿脐动脉和大脑中动脉血流动力学参数[收缩期峰值(PSV)、舒张期末最大血流速度(EDV)、阻力指数(RI)、搏动指数(PI)、PSV与EDV之比(S/D)],比较各体位时参数变化,并与胎儿出生后1 min Apgar评分结果作比较,评估彩色多普勒超声检测预测胎儿宫内缺氧的价值。结果妊娠晚期孕妇不同体位时胎儿脐动脉血流动力学参数比较,仰卧位PSV、RI和PI均高于左、右侧卧位,EDV均低于左、右侧卧位,S/D高于右侧卧位,差异有统计学意义(P0.01);左侧卧位EDV高于右侧卧位,差异有统计学意义(P0.01)。妊娠晚期孕妇不同体位时胎儿大脑中动脉血流动力学参数比较,左侧卧位RI和PI均低于右侧卧位,差异有统计学意义(P0.01);仰卧位PSV、RI、PI和S/D均高于左、右侧卧位,EDV均低于左、右侧卧位,差异有统计学意义(P0.01)。本组新生儿出生后1 min Apgar评分8~10分者61例,4~8分者6例;仰卧位与左、右侧卧位时彩色多普勒超声检测胎儿大脑中动脉与脐动脉RI比值均1,轻度窒息6例均未能在彩色多普勒超声检测中被预测。结论妊娠晚期孕妇不同体位对彩色多普勒超声检测胎儿脐动脉和大脑中动脉血流动力学参数有明显影响,胎儿脐动脉和大脑中动脉血流动力学参数难以预测新生儿轻度窒息。     

经阴道彩超检测正常和病理早期妊娠黄体血流状况的探讨

目的观察比较正常和病理早期妊娠中的黄体血流状况,分析其意义。方法采用经阴道彩超声检查215例早期妊娠的孕妇,检出妊娠黄体205例,其中正常早期妊娠组148例、先兆流产组25例、宫外孕组22例,观察卵巢内黄体血流分布特点,检测收缩期峰值流速Vmax)、阻力指数RI及搏动指数PI。结果(()()1经阴道彩超对早期妊娠黄体总检出率95.3%,其中正常组检出率99.38/150);先兆流产组96.1%/26);宫外孕组75.8%(((22/29)。2三组妊娠黄体血流分布特点无差异,均呈连续环状分布。3先兆流产组黄体血流的PVS、PI、RI与正常早期妊娠组比较无差异(P>0.05),宫外孕组病人的黄体血流PVS比正常妊娠组的PVS低(P<0.05),PI、RI与正常组比较无差异(P>0.05)。结论经阴道彩色多普勒超声可以准确地识别妊娠黄体,血流指标中收缩期峰值流速在鉴别正常早孕与宫外孕可能有一定帮助。     

彩色多普勒超声评价腹膜透析患者肠系膜上动脉血流动力学变化

目的 通过彩色多普勒技术测量尿毒症腹膜透析(PD)患者、尿毒症非PD患者及正常健康人肠系膜上动脉(SMA)血流动力学参数,探讨PD对尿毒症患者SMA血流动力学的影响.方法 应用Philips飞凡型彩色多普勒超声诊断仪对尿毒症PD患者、尿毒症非PD患者及健康志愿者各30例进行SMA血流动力学参数测量.结果 三组间收缩期峰值流速(PSV)、管径(D)差异无统计学意义(P>0.05);尿毒症PD组阻力指数(RI)、搏动指数(PI)低于对照组及尿毒症非PD组,差异有统计学意义(P<0.05),而尿毒症非PD组与对照组间RI、PI差异无统计学意义(P>0.05);尿毒症PD组舒张末期流速(EDV)、时间平均流速TAVM、血流量Q高于对照组及尿毒症非PD组,差异有统计学意义(P<0.05),而尿毒症非PD组与对照组间EDV、TAVM、Q差异无统计学意义(P>0.05). 尿毒症PD组RI、PI与PD龄呈负相关(r=-0.91, P<0.05;r=-0.66, P<0.05).结论 彩色多普勒超声可以无创地评价尿毒症PD患者SMA血流动力学情况,其中RI、PI的下降对于PD患者SMA血流动力学损害有重要提示意义.     

Evaluation of differences between observers and automatic-manual measurements in calculation of Doppler parameters.

OBJECTIVE: We aimed to search for differences between observers and automatic and manual measurements in calculations of Doppler parameters. METHODS: The middle cerebral artery (MCA), central retinal artery, ophthalmic artery (OA), common carotid artery (CCA), vertebral artery (VA), popliteal artery (PA), interlobar renal artery (IRA), and arcuate renal artery (ARA) were evaluated in 20 healthy subjects bilaterally. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistive index (RI), and pulsatility index (PI) were measured from the same spectrum manually by 3 observers and automatically. Results of 4 measurements were compared by analysis of variance and Pearson tests. RESULTS: The comparison of the 4 measurements revealed significant differences for most parameters except TAMAX of the OA, VA, and ARA and PSV, EDV, and PI of the PA. An automatic calculator yielded lower PSV, RI, and PI values (except the MCA and PA) and higher EDV values compared with manual measurements. The magnitudes of difference were in the range of 1% to 16% for velocities and 4% to 14% for RI and PI. The means of difference were 3.185 cm/s for PSV of the CCA and 0.054 for RI of the IRA. Correlation was high for PSV, EDV, and TAMAX in all arteries (except TAMAX of PA) and relatively low for PI and RI in most of the arteries. CONCLUSIONS: Although our study was performed on healthy subjects, our results showed that, in most cases, readers and the automatic approach disagreed on evaluation of Doppler parameters. This may be important in preventing false diagnoses in cases with Doppler values close to upper limits and may necessitate establishment of new limits for each method.     

经阴道彩色多普勒超声对妊娠黄体的检测价值探讨

目的　通过经阴道彩色多普勒超声对妊娠黄体的检测 ,探讨其对于诊断早期妊娠及评估预后的价值。方法　正常早孕组 5 0例 ,先兆流产组 4 5例 ,胚囊型宫外孕组 8例 ,分为三组。分别观测妊娠黄体形态、血供分布、血流动力学参数 ,追踪回访 ,作回顾性统计学处理分析。结果　三组妊娠黄体回声类型无显著统计学差异 ;正常早孕组血供丰富 ,呈中速低阻连续型 [PSV(32 .6± 6 .4 ) cm/ s、RI0 .4 6± 0 .0 5 ],先兆流产组血供欠丰富甚或缺如 ,频谱阻力指数偏高 (RI0 .5 7± 0 .0 3) ,宫外孕胚囊型组介于两者之间 (RI0 .5 0± 0 .0 3) ,有统计学差异 (P<0 .0 5 )。结论　通过彩色多普勒超声检测妊娠黄体的功能状态对于早期妊娠的鉴别诊断及预后的估测有重大意义。     

Doppler blood flow velocity waveforms in the fetal renal arteries: variability at proximal and distal sites in the right and left arteries.

OBJECTIVE: To investigate variability in pulsatility/resistance indices and absolute velocities of blood flow in fetal renal arteries dependent on side and sampling site within each vessel. METHODS: Doppler blood flow measurements of pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV) and end-diastolic velocity (EDV) were performed in the renal arteries of 27 fetuses between 236 and 247 days of gestation. Velocity waveforms were sampled in both the right and left renal arteries at two different sites: proximally, close to the aorta, and distally, before any major visible bifurcation of the vessels. The intraobserver variation was measured in 15 additional fetuses. RESULTS: Mean values of PI and RI were similar in the right and left renal arteries and at the proximal and distal sampling sites of these arteries. Mean PSV and EDV were higher at the proximal compared to the distal site on both sides. For all parameters the 95% limits of agreement between measurements made in the right and left arteries and at proximal and distal sites were wide but tended to be narrower for the left renal artery and at the distal site. Intraclass correlation coefficients for intraobserver variability were 0.88, 0.89, 0.83 and 0.81 for PI, RI, PSV and EDV, respectively. CONCLUSIONS: It is important to standardize the precise site at which Doppler blood flow velocity waveform measurements are made in the renal arteries of the fetus. On the basis of our observations, we suggest that the left renal artery is the preferred vessel for sampling and that measurements should be made in the renal arterial trunk away from the aorta and before any visible branches.     

正常青春期睾丸动脉血流参数与睾丸体积的相关性研究

目的:研究正常青春期睾丸各动脉血流参数与睾丸体积的相关性。方法:检测141例正常青春期男性的睾丸体积及睾丸内动脉(ITA)、睾丸包膜动脉(CA)、睾丸动脉(TA)的时间平均峰值血流速度(TAMX)、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)和搏动指数(PI)、收缩期峰值/舒张末期血流速度(S/D)。各血流参数均与睾丸体积做相关性研究。结果:正常青春期ITA,CA,TA的TAMX,PSV和EDV均与睾丸体积存在正相关,相关系数均为1.00(P<0.01)。而PI,RI,S/D均与睾丸体积无相关性。结论:正常青春期ITA,CA,TA的血流速度均随睾丸体积的增大而逐渐增高,相关性良好。     

The role of Doppler sonography in predicting severity of acute pancreatitis

PURPOSE: To investigate the role of Doppler sonography (DUS) examination of major abdominal arteries in predicting severity of acute pancreatitis (AP). METHODS: Twenty-nine patients diagnosed with AP and 14 controls were blindly and prospectively evaluated with Doppler sonography. Disease severity was defined clinically according to acute physiology and chronic health evaluation (APACHE II) score and was classified as severe for APACHE II score > or =8. DUS examination included the measurement of peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI) of the celiac artery (CA) and superior mesenteric artery (SMA). Statistical analysis included Mann-Whitney U test, Student t test, and receiver operating characteristic curve analysis. RESULTS: Twelve patients had severe AP and 17 had mild AP. PSV, EDV, and PI of the CA and RI of the SMA were higher in the severe AP group than in the mild AP and control groups (p < 0.001 and p < 0.0001, respectively). The sensitivity and specificity were 100% and 94%, respectively, for a 87 cm/second CA PSV cutoff value, 75% and 100%, respectively, for a 22 cm/second CA EDV cutoff value, 92% and 82%, respectively, for a 1.29 CA PI cutoff value, and 100% and 100%, respectively, for a 0.86 SMA RI cutoff value. CONCLUSION: DUS can be useful in predicting the severity of AP in the early period of admission phase of the disease.     

Assessment of renal circulation in small for gestational age and appropriate for gestational age term newborns: a prospective study

PURPOSE: To compare selected parameters of renal circulation between small for gestational age (SGA) and appropriate for gestational age (AGA) newborns. METHODS: Fifty-two SGA and 100 AGA term newborns were examined. The size of the kidneys were measured, and renal blood flow in the central and intraparenchymal renal arteries were assessed via Doppler sonography. Peak systolic velocity (PSV), end diastolic velocity (EDV), mean blood flow velocity (V mean), resistance index (RI), and pulsatility index (PI) were determined and compared between the groups. RESULTS: No statistically significant differences in the velocity parameters were found between SGA and AGA infants in central renal arteries. Slightly higher RIs and PIs were seen in AGA newborns (RI, 0.76 +/- 0.13 versus 0.78 +/- 0.06 [p < 0.05]; PI, 1.65 +/- 0.54 versus 1.84 +/- 0.46 [p < 0.05]). There were statistically significant differences between the groups in all measured parameters in intraparenchymal arteries (RI, 0.57 +/- 0.11 versus 0.63 +/- 0.05 [p < 0.001]; PI, 0.89 +/- 0.26 versus 1.09 +/- 0.16 [p < 0.001]) except PSV (7.11 +/- 1.55 versus 7.14 +/- 0.81 cm/s [p > 0.05]). CONCLUSION: Based on our findings, we suggest that renal circulation is not negatively influenced by intrauterine growth restriction in SGA neonates compared with AGA newborns.     

彩色多普勒超声对兔膝骨性关节炎诊断及治疗的实验研究

目的　探讨彩色多普勒超声对实验性膝骨性关节炎诊断及治疗疗效观察的应用价值。方法　对 3 6只大白兔实验性膝骨性关节炎做治疗前后患肢股动脉下段的彩色多普勒超声检测 ,并做血液流变学及病理学分析。结果　患肢股动脉下段血流速明显减缓 ,阻力指数、搏动指数升高 (P <0 .0 1) ,关节表面粗糙 ,软骨变薄 ,关节腔积液。治疗后血流速增加 ,阻力指数、搏动指数降低 (P <0 .0 5 ) ,关节表面回声变清晰。结论　彩色多普勒超声对膝骨性关节炎的诊断及治疗疗效的观察具较高的应用价值     

实验性膝骨性关节炎的彩色多普勒研究

本文对６只纯种新西兰大白兔的实验性膝骨性关节炎作了彩色多普勒血流显像（ＣＤＦＩ）研究，比较兔健患侧股动脉的阻力指数（ＲＩ）、搏动指数（ＰＩ）、收缩期峰值速度（ＰＳＶ）、舒张末期流速（ＥＤＶ）及加速度（ＡＣＣ）。结果表明：与健侧相比，患侧的ＰＳＶ、ＥＤＶ和ＡＣＣ显著降低（Ｐ＜０．０５），而ＲＩ则显著增高（Ｐ＜０．０５）。提示：ＣＤＦＩ作为一种无创的检查方法有助于膝骨性关节炎的诊断     

Repeatability of power Doppler sonography of cervical lymph nodes

This study was undertaken to investigate the repeatability (intraobserver variability) of power Doppler sonography in assessment of cervical lymph nodes. Power Doppler sonography was performed twice in 20 healthy subjects to evaluate the repeatability of measurement of size, blood flow velocity (peak systolic velocity, PSV, and end diastolic velocity, EDV) and vascular resistance (resistance index, RI, and pulsatility index, PI) of cervical nodes. A total of 70 power Doppler sonograms were reviewed to evaluate the repeatability of assessment of vascular pattern, degree of vascularity and displacement of vessels of cervical lymphadenopathy. In the 20 subjects, 139 normal cervical nodes were detected in the first scan and they were re-scanned in the second scan. One node was detected in the second scan, but not in the first scan. Of the total, 50 cervical nodes showed arterial flow in both scans, and blood flow velocity and vascularity resistance were measured. The mean value of PSV, EDV, RI and PI have a higher repeatability than their highest and lowest values. There is a high repeatability in the measurement of maximum transverse diameter (97%), mean PSV (95%), mean EDV (96%), mean RI (86%) and mean PI (87%). The repeatability in evaluation of vascular pattern (85%), degree of vascularity (95%) and displacement of vessels (88%) are also high. Results suggest that power Doppler sonography is a reliable method in assessment of the vasculature of cervical lymph nodes.