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1.
彩超诊断肝移植术后肝动脉血栓和狭窄的价值   总被引:2,自引:1,他引:2  
目的:探讨彩超对肝移植术后肝动脉血栓和狭窄的诊断价值。方法:彩超检查135例肝移植术后患者的肝实质回声、肝动脉血流、肝动脉阻力指数、收缩期加速度时间、频谱流速曲线形态。结果:彩超发现肝动脉血栓7例。4例出现肝内单发或多发低回声区,6 例显示肝门或肝内无动脉血流,1例表现为肝动脉阻力指数降低和收缩期加速度时间延长,肝动脉狭窄2例,肝动脉阻力指数降低和收缩期加速度时间延长。结论:彩超对肝移植术后肝动脉并发症的检测具有重要价值。  相似文献   

2.
彩色多普勒超声对肝移植术后并发症的诊断价值   总被引:3,自引:0,他引:3  
目的评价彩色多普勒超声对肝移植术后并发症的诊断价值。方法回顾性分析和总结26例肝移植术后并发症的彩色多普勒超声检查资料,检测指标包括肝动脉及左右分支的峰值速度(HAPV)、阻力指数(RI)、加速度及加速时间,门静脉平均流速,肝实质及胆管回声。结果6例经手术或造影证实为血管并发症(肝动脉血栓形成1例,肝动脉狭窄2例,肝动脉痉挛1例,门静脉狭窄2例),彩色多普勒超声表现有肝动脉狭窄处的高速高阻血流并伴有湍流,而狭窄远端峰值速度〈40cm/s,RI〈0.5,加速时间〉0.08s,加速度〈300cm/s^2,1例肝动脉血栓形成肝门部无动脉血流信号;6例急性排斥反应,3例胆管结石并扩张。结论彩色多普勒超声对肝移植术后血管并发症的诊断具有重要的指导意义。  相似文献   

3.
PURPOSE: To determine whether quantitative and qualitative analysis of intraoperative Doppler sonography data are predictive of vascular complications after living-related donor liver transplantation. METHODS: Intraoperative sonograms of 81 transplanted livers (right lobe in 61 patients, left lobe in 20 patients) were analyzed for the presence of blood flow, resistance index, systolic acceleration time (SAT), peak systolic velocity, and morphologic characteristics of spectral waveform of the hepatic artery. Peak velocity and spectral waveforms of portal and hepatic veins were also analyzed. Intraoperative sonography results were compared with information obtained with multidetector-row CT (MDCT) angiography or conventional angiography. The time interval between operation and angiography ranged from 1 to 23 days (mean, 8.5 days). RESULTS: Hepatic artery stenosis (HAS) was identified in 20 patients via MDCT angiography, conventional angiography, or both. The Doppler parameters found helpful for predicting HAS were tardus-parvus pattern and delayed SAT. The sensitivity, specificity, and negative predictive value (NPV) were 60.0%, 73.7%, and 84.9%, respectively, for tardus-parvus pattern and 40.0%, 83.6%, and 80.9%, respectively, for delayed SAT. Peak velocities of the portal and hepatic veins were not reliable indicators of vascular complication. Loss of triphasity of the hepatic vein had a 98.4% NPV for venous obstruction. CONCLUSIONS: Delayed SAT of the hepatic artery and loss of triphasity of the hepatic vein had a >80% for specificity for predicting vascular complications. Tardus-parvus pattern, delayed SAT of the hepatic artery, and loss of triphasity of the hepatic vein showed an acceptable NPV for identifying vascular complications.  相似文献   

4.
To determine the feasibility of using UltraFast Doppler in post-operative evaluation of the hepatic artery (HA) after liver transplantation (LT), we evaluated 283 simultaneous conventional and UltraFast Doppler sessions in 126 recipients over a 2-mo period after LT, using an Aixplorer scanner The Doppler indexes of the HA (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI] and systolic acceleration time [SAT]) by retrospective analysis of retrieved waves from UltraFast Doppler clips were compared with those obtained by conventional spectral Doppler. Correlation, performance in diagnosing the pathologic wave, examination time and reproducibility were evaluated. The PSV, EDV, RI and SAT of spectral and UltraFast Doppler measurements exhibited excellent correlation with favorable diagnostic performance. During the bedside examination, the mean time spent for UltraFast clip storing was significantly shorter than that for conventional Doppler US measurements. Both conventional and UltraFast Doppler exhibited good to excellent inter-analysis consistency. In conclusion, compared with conventional spectral Doppler, UltraFast Doppler values correlated excellently and yielded acceptable pathologic wave diagnostic performance with reduced examination time at the bedside and excellent reproducibility.  相似文献   

5.
Vertebrobasilar intracranial stenoses seem to carry a higher risk of brain stem ischemia than proximal vertebral artery stenoses. Our aim was to assess the value of transcranial Doppler sonography versus angiography in detecting and quantifying these intracranial stenoses. All consecutive patients who underwent transcranial Doppler sonography prior to angiography from 1989 to 1994 and whose sonograms showed a stenosis of greater than 50% of one vertebral artery (21 cases) or of the basilar artery (eight cases) were included in the study. These patients were compared with 60 other consecutive stroke patients studied via transcranial Doppler sonography prior to normal vertebrobasilar angiography The transcranial Doppler sonographic criteria for stenosis were a peak systolic frequency shift greater than 2 KHz. A tight stenosis was identified by this pattern combined with direct and reverse low frequencies of high spectrum energy. The sensitivity of transcranial Doppler sonography using a peak systolic frequency shift in diagnosing stenoses reached 80% and its specificity was 97% if only atheromatous stenoses were considered. The main diagnostic failures concerned bilateral stenoses or contralateral occlusion, tandem lesions, and upper basilar artery stenosis. Transcranial Doppler sonography underestimated the degree of stenosis compared to angiography in 55% of the cases. We conclude that transcranial Doppler sonography is accurate in recognizing a stenosed vessel in the intracranial vertebrobasilar circulation, but if this finding will alter therapy, the examination must be complemented by magnetic resonance angiography.  相似文献   

6.
PURPOSE: We assessed the usefulness of color Doppler imaging in the diagnosis and monitoring of arterial complications after liver transplantation. METHODS: Subjects were 142 liver transplant recipients who underwent serial color Doppler sonographic evaluations of the hepatic arteries after surgery. Patients with abnormal sonographic findings underwent subsequent angiography. RESULTS: Eighteen subjects experienced 20 hepatic arterial complications (13 thromboses and 7 stenoses). In 7 of the 13 thrombosis incidents, hepatic arterial obstruction occurred within a month of surgery and was evident from the absence of Doppler signals; angiography confirmed the absence of hepatic arterial perfusion in these cases. In the other 6 thrombosis cases, the thrombosis developed 3 or more months after surgery and became apparent from the absence of color Doppler signals at the level of the main arterial trunk and the presence of intraparenchymal "tardus parvus" waveforms. In these cases, angiography showed obstruction of the main arterial trunk and the development of compensatory collateral vessels. In 3 of the 7 cases of stenosis, high flow velocities were recorded at the site of the narrowing, and intrahepatic tardus parvus waveforms were present. In the other 4 stenosis cases, the site of stenosis could not be identified, but intraparenchymal tardus parvus waveforms were recorded. CONCLUSION: The use of color Doppler sonography allows the early diagnosis of hepatic arterial complications after liver transplantation. Tardus parvus waveforms indicated severe impairment of hepatic arterial perfusion, from either thrombosis or severe stenosis. The presence of these waveforms enhanced the accuracy of color Doppler diagnosis (100% positive predictive value), and their detection should prompt angiography.  相似文献   

7.
彩色多普勒超声在肝移植血管并发症中的应用价值   总被引:3,自引:0,他引:3  
目的 确定彩色多普勒超声成像(CDFI)技术在肝移植血管并发症中应用价值。方法 应用彩色多普勒及频谱多普勒技术对26例肝移植病例(7例小儿部分肝移植及19例成人肝移植)进行术前评价,术中指导及术后监测,重点观察受体术后至少180d内肝血流动力学各项参数及肝脏动、静脉及门静脉血流频谱形态变化,及时发现血管狭窄及血栓等严重并发症。结果 26例肝移植病例,术后CDFI及时发现肝动脉狭窄(HAS)1例及肝动脉血栓(HAT)1例,经过血管造影证实。发现门静脉血栓1例,肝静脉狭窄2例,经过再次手术取栓及狭窄处球囊扩张后,血流灌注恢复正常。结论 应用CDFI监测各项血流指标,对于术后早期发现肝脏血管狭窄及血栓等严重并发症具有较高的敏感性和特异性,提高了手术的成功率和患者的生存率。  相似文献   

8.
罗燕  张梅  周琛云  卢强  蔡迪明 《华西医学》2006,21(4):710-711
目的:探讨彩色多普勒超声在活体肝移植术后肝动脉并发症中的诊断价值。方法:回顾分析和总结了21例活体供肝移植术后肝动脉并发症的发生情况及彩色多普勒超声检查结果。结果:超声诊断肝动脉栓塞2例并分别被手术及血管造影证实,误诊肝动脉栓塞1例,被尸体解剖证实,无漏诊病例。误诊肝动狭窄1例。结论:彩色多普勒超声能够早期发现肝动脉栓塞并评价治疗效果,但需注意排出肝动脉栓塞及肝动脉狭窄的假阳性。  相似文献   

9.
目的:探讨肝移植术后早期的常规彩色及频谱多普勒超声检查在检出肝动脉血栓形成中的价值。方法:对38例原位肝移植的患者于术后2周内常规每日行彩色及频谱多普勒超声检查,根据彩色和频谱的异常情况判定有无肝动脉血栓形成,其中有8例行动脉造影,1例死亡病例行尸体解剖,所有存活病例均行随诊观察。结果:共6例患者经造影或尸体解剖证实有肝动脉血栓形成,其中5例多普勒超声表现为肝门及肝内均未探及肝动脉血流信号,1例表现为频谱圆钝且流速减低,其余病例均无肝动脉血栓形成。结论:肝移植术后常规行彩色及频谱多普勒超声检查在早期诊断肝动脉血栓形成中起着重要作用。  相似文献   

10.
目的:通过经颅彩色多普勒对颅内动脉狭窄患者经皮血管内支架成型术前后血流动力学改变与脑血管造影的对照,评价经颅彩色多普勒在颅内动脉狭窄经皮血管内支架成型术中的价值。方法:58例颅内动脉狭窄的患者经皮血管内支架成型术治疗后,其病变血管的血流动力学多项指标(Vm,Vs,Vd,PI,RI)与治疗前进行比较。结果:51例患者与术前比Vs,Vm,Vd下降,PI值增高,RI值变化不大,经颅彩色多普勒及脑血管造影随访所有患者无再发狭窄;5例患者出现Vs,Vm,Vd增快,PI值增高,但均未见反流信号;2例出现Vs增快,Vm增快,Vd降低。中、重度狭窄经颅彩色多普勒与脑血管造影相符率较高,分别占89%,83%。结论:经颅彩色多普勒与脑血管造影均可作为经皮血管内支架成型术术前术后血流动力学改变的评价手段。  相似文献   

11.
目的探讨彩色多普勒超声(CDUS)对活体供肝肝移植(living donor liver transplant,LDLT)术后并发症的诊断价值。方法回顾分析2000年1月~2005年6月间我院进行的21例LDLT术后彩色多普勒超声的检查结果。结果发现1例肝动脉栓塞被动脉造影证实,1例门静脉栓塞,1例右肝静脉流出道梗阻。误诊1例肝动脉栓塞,尸解肝动脉正常。所有患者均有不同范围及程度的胸腹腔积液。结论彩色多普勒超声检查可以早期发现活体供肝肝移植的术后并发症并评价治疗效果。  相似文献   

12.
多层螺旋CT血管成像在肝移植前后的诊断价值   总被引:3,自引:0,他引:3       下载免费PDF全文
目的评价多层螺旋CT(MSCT)在肝移植手术前后的临床应用价值.方法 7例肝移植患者(男6例,女1例,平均年龄45岁),手术前后1周内均行MSCT肝脏平扫、动态多期增强扫描、3D血管重建、体积测量,CT结果与手术进行对照.结果肝硬化7例,伴有严重肝萎缩2例、小肝癌4例.3D血管成像:100%显示肝总动脉、门静脉、肝静脉起源、长度及主分支;1例肝动脉变异起自肠系膜上动脉,肝总动脉狭窄1例,门静脉狭窄1例,门静脉主干血栓1例,移植后血管并发症1例.术前、术后CT结果均与术中相符.结论 MSCT在肝移植手术前后是一种可行性检查方法,能准确、客观反映肝实质及肝血管情况.  相似文献   

13.
Hepatic artery aneurysms are rare vascular lesions sometimes found incidentally during abdominal imaging. We present the case of a 61-year-old man whose initial symptoms were tenderness in the right upper quadrant of the abdomen and epigastric pain. Gray-scale sonography revealed ascites and an 8.1-cm mass in the region of the porta hepatis; color Doppler sonography revealed a turbulent arterial waveform with high peak systolic velocity. We diagnosed a giant aneurysm of the common hepatic artery. Three-dimensional CT angiography confirmed this diagnosis and also revealed hemoperitoneum. The patient underwent aneurysmectomy and recovered well. This case shows that the use of both sonography and CT angiography offers a promising alternative to conventional angiography for the diagnosis of and treatment planning for hepatic artery aneurysms.  相似文献   

14.
彩超诊断人工血管内血栓形成的价值   总被引:4,自引:0,他引:4  
目的 探讨彩超对人工血管内血栓形成的诊断价值。方法 彩超检查23例患者,共28条可疑形成血栓的人工血管,观测人工血管的回声、管腔内血流及频谱流速曲线形态,均经手术或造影证实。结果 人工血管内血栓形成后,管腔狭窄者11条,管腔显著狭窄者7条,管腔闭塞者10条。结论 彩色多普勒超声对人工血管内血栓形成的检测具有重要价值。  相似文献   

15.
颅内动静脉畸形的术中超声应用研究   总被引:1,自引:0,他引:1  
目的探讨超声在颅内动静脉畸形手术中的应用价值。方法对22例颅内动静脉畸形患者术中采用超声确定畸形血管团的数目、位置、深度、大小、范围及其与周边组织结构的关系,探查其供血动脉及引流静脉的数目及走行;手术前后采用频谱多普勒检测供血动脉及引流静脉的血流动力学参数,并观察频谱形态。结果22例患者术中超声准确定位畸形血管团位置和边界,16例超声可探及明显供血动脉及引流静脉,6例术中未探及明显供血动脉及引流静脉,术后病理证实为动静脉畸形部分呈海绵状血管瘤结构。2例患者术后行彩色多普勒超声扫查显示仍有畸形血管团残留,指导切除残留畸形血管。颅内动静脉畸形供血动脉多普勒频谱呈高速低阻型,RI较正常血管明显降低,为0.23~0.42,平均0.34±0.06,术后显著升高为0.47~0.59,平均0.51±0.04,手术前后相比差异有统计学意义(P<0.01)。结论术中超声可实时定位颅内动静脉畸形位置,根据脉冲多普勒频谱特征确认供血动脉和引流静脉,减少脑组织损伤,缩短手术时间,判断手术切除完整性。  相似文献   

16.
Objective . To describe the spectral and color Doppler imaging findings in 2 cases of internal carotid artery occlusion with vasa vasorum collateral flow, which we term the “pseudostring sign.” Methods . Spectral and color Doppler imaging findings in both cases were reviewed. Magnetic resonance angiography in 2 cases and conventional angiography in 1 case were also reviewed. Results . Both patients had color Doppler images showing that the internal carotid artery was a narrow, stringlike vessel with arterial flow that had normal spectral Doppler features (velocity <125 cm/s with a normal waveform). Magnetic resonance angiography in 1 patient showed total occlusion of the proximal internal carotid artery with patent vasa vasorum collaterals reconstituting the lumen distally. In the second patient, magnetic resonance angiography showed total occlusion of the proximal internal carotid artery, and conventional angiography showed proximal occlusion with collateral flow through the vasa vasorum. Conclusions . Proximal internal carotid artery occlusion with vasa vasorum collateral flow should be considered when color Doppler imaging shows a seemingly narrow internal carotid artery with tortuosity and normal spectral Doppler features. Patients with these features should not undergo carotid endarterectomy directly on the basis of only the Doppler findings.  相似文献   

17.
目的探讨彩色多普勒超声在支架置人术治疗颅外段颈动脉粥样硬化性狭窄中的作用。方法49例因颅外段颈动脉粥样硬化性狭窄行自膨胀式颈动脉支架置人术的患者,在术前应用彩色多普勒超声测量狭窄处内径、狭窄率,与数字减影血管造影(DSA)比较;在术后1个月和术后12个月测量狭窄处内径、收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI),并与术前比较。结果彩色多普勒超声测量的狭窄处内径及狭窄率与DSA测值比较差异无统计学意义(P〉0.05);术后1个月与12个月比较,狭窄处内径、PSV、EDV及RI差异无统计学意义(P〉0.05),与术前比较狭窄处内径均显著增大(P〈0.05),PSV、EDV及RT均显著减小(P〈0.05)。1例患者在术后12个月随访时发现支架内再狭窄,经DSA证实后再次行支架治疗。结论彩色多普勒超声对颅外段颈动脉粥样硬化性狭窄的诊断准确性较高,可用于支架置入术前颈动脉狭窄的初选和术后的疗效评价及随访。  相似文献   

18.
目的 观测2型糖尿病患者脉络膜血管的血流参数变化.方法 应用彩色多普勒超声测量54例(108只眼)2型糖尿病患者和81名正常对照者脉络膜血管的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、收缩期加速时间(SAT)、加速度(A)、加速时间与心动周期之比(R),并与正常对照组比较,分析性别、年龄、身高、体质量、糖尿病病程、血糖水平和高血压与各血流参数的相关性,测量睫状后短动脉的PSV、EDV和RI,比较两血管血流参数变化的一致性.结果 与正常对照组比较,2型糖尿病患者脉络膜血管的PSV、EDV降低,RI增高,R增大,差异有统计学意义(P<0.05),与睫状后短动脉的变化一致;SAT、A与正常对照组的差异无统计学意义(P>0.05).PSV与糖尿病病程、年龄均呈负相关(P<0.05);RI与病程、年龄和血糖水平均呈正相关(P<0.05);R与病程、年龄均呈正相关(P<0.05).结论 应用彩色多普勒超声检测2型糖尿病脉络膜血管的血流参数变化可以反映糖尿病脉络膜病变的血液循环状态,为临床诊断起到提示作用.  相似文献   

19.
Background We attempted to identify the physiologic circumstances associated with the portal Doppler waveform. Method The subjects were 98 patients: 42 had cirrhosis; 23, hepatitis; and 33, no liver disorder. We measured right portal venous peak velocity, minimum velocity, and hepatic arterial peak systolic velocity. Portal venous pulsatility was calculated as portal venous minimum velocity divided by portal venous peak velocity. We analyzed portal waveforms both qualitatively and quantitatively. Results Portal Doppler waveforms were classified as nonphasic, monophasic, biphasic, biphasic including spike wave, and triphasic. Portal waveforms were phasic in 84 subjects who had a mild systolic dip during the arterial systolic period. Markedly portal pulsatility (portal venous pulsatility<0.6) was present in only 7 subjects. A systolic spike wave corresponding to a hepatic arterial peak systolic wave was detected in 48 subjects. Hepatic arterial peak systolic velocity was significantly higher in the group with spike wave than in the group without it. Conclusion Although portal pulsatility is generally attributed to multiple factors, the present study has pointed out a new factor; transmission via the hepatic artery through the portal vein vasa vasorum. Hepatic venous drainage and hepatic arterial blood flow influence portal waveform.  相似文献   

20.
目的 探讨颈动脉多普勒超声(CDU)评估颈内动脉(ICA)颅内段重度狭窄性疾病的应用价值.方法 回顾性连续纳入2018年1月至2019年12月于苏州大学附属第一医院卒中中心就诊,经CT血管造影(CTA)和(或)数字减影血管造影(DSA)证实的单侧ICA颅内段重度狭窄或闭塞、并行CDU检查的患者171例作为研究组;纳入同...  相似文献   

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