经阴道彩色多普勒超声诊断子宫肌瘤的对比研究

目的　探讨经阴道彩色多普勒超声 (TVCDS)对子宫肌瘤的诊断价值 .方法　采用TVCDS检查子宫肌瘤患者 5 0例 ,测量子宫动脉的血流速度 ,阻力指数 (RI) ,观察肌瘤的血供情况 .5 2例健康妇女作为正常对照组 .结果　 5 0例子宫肌瘤患者子宫动脉平均RI低于正常对照组 (p <0 .0 1) .子宫肌瘤瘤体周边血供较瘤体内部丰富 ,肌瘤周边RI高于内部 .浆膜下肌瘤及粘膜下肌瘤的蒂部显示血流丰富 ,由子宫穿入肌瘤内 .结论　TVCDS具有高分辨率特点 ,并能提供高敏感性的血流信息     

彩色多普勒血流显像与彩色多普勒能量图在恶性滋养细胞肿瘤的应用

目的探讨彩色多普勒血流显像(CDFI)及彩色多普勒能量图(CDE)在恶性滋养细胞肿瘤(GTD)早期诊断及化疗监测中的应用价值. 方法对20例GTD进行CDFI、CDE检测,观察其血流情况及用PD检测病变区血流速度,测算RI值. 结果 CDFI显示病变区血流异常丰富,CDE显示更丰富的血流信号.PD检测出低阻血流,RI=0.41±0.07,化疗前后相比CDFI、CDE和PD改变明显,RI值差异有非常显著性意义(p<0.01). 结论 CDFI、C DE对恶性滋养细胞肿瘤诊断及观察疗效均有十分重要的价值.     

彩色多普勒血流显像与彩色多普勒能量图在恶性滋养细胞肿瘤的应用

目的探讨彩色多普勒血流显像(CDFI)及彩色多普勒能量图(CDE)在恶性滋养细胞肿瘤(GTD)早期诊断及化疗监测中的应用价值.方法对20例GTD进行CDFI、CDE检测,观察其血流情况及用PD检测病变区血流速度,测算RI值.结果CDFI显示病变区血流异常丰富,CDE显示更丰富的血流信号.PD检测出低阻血流,RI=0.41±0.07,化疗前后相比CDFI、CDE和PD改变明显,RI值差异有非常显著性意义(p<0.01).结论CDFI、CDE对恶性滋养细胞肿瘤诊断及观察疗效均有十分重要的价值.     

经阴道彩色多普勒超声诊断子宫肌瘤的对比研究

目的探讨经阴道彩色多普勒超声(TVCDS)对子宫肌瘤的诊断价值.方法采用TVCDS检查子宫肌瘤患者50例,测量子宫动脉的血流速度,阻力指数(RI),观察肌瘤的血供情况.52例健康妇女作为正常对照组.结果 50例子宫肌瘤患者子宫动脉平均RI低于正常对照组(p<0.01).子宫肌瘤瘤体周边血供较瘤体内部丰富,肌瘤周边RI高于内部.浆膜下肌瘤及粘膜下肌瘤的蒂部显示血流丰富,由子宫穿入肌瘤内.结论 TVCDS具有高分辨率特点,并能提供高敏感性的血流信息.     

输尿管软镜碎石术围手术期肾彩色多普勒超声血流动力学评价

目的　彩用彩色多普勒超声（CDFI）对单发肾结石患者输尿管软镜碎石术围手术期肾血流动力学的评价。 方法　分析2016年7月至2018年6月共61例输尿管软镜碎石手术的单发肾结石患者,应用CDFI观察围手术期术侧肾叶间动脉血流参数,记录术前1 d、术后1 h内及术后5 d叶间动脉血流参数,并进行统计学分析。 结果　围手术期肾叶间动脉血流参数整体分析,收缩期峰值流速（Vmax）、舒张末期流速（Vmin）及阻力指数（RI）数值差异分别具有统计学意义（P<0.05）。与术前血流参数相比,术后1 h叶间动脉Vmax及Vmin均减低,RI增高（P<0.017）,术后5 d复查,Vmax及Vmin较术后1 h升高、RI较术后1 h减低（P<0.017）,与术前测值相比差异无统计学意义（P>0.017）。 结论　CDFI可以观察并量化输尿管软镜碎石术围手术期肾内动脉灌注,快速评价术侧肾血流动力学变化,手术后会出现短期、可逆性肾叶间动脉流速减低、RI增高。     

输尿管软镜碎石术围手术期肾彩色多普勒超声血流动力学评价

目的　彩用彩色多普勒超声（CDFI）对单发肾结石患者输尿管软镜碎石术围手术期肾血流动力学的评价。 方法　分析2016年7月至2018年6月共61例输尿管软镜碎石手术的单发肾结石患者,应用CDFI观察围手术期术侧肾叶间动脉血流参数,记录术前1 d、术后1 h内及术后5 d叶间动脉血流参数,并进行统计学分析。 结果　围手术期肾叶间动脉血流参数整体分析,收缩期峰值流速（Vmax）、舒张末期流速（Vmin）及阻力指数（RI）数值差异分别具有统计学意义（P<0.05）。与术前血流参数相比,术后1 h叶间动脉Vmax及Vmin均减低,RI增高（P<0.017）,术后5 d复查,Vmax及Vmin较术后1 h升高、RI较术后1 h减低（P<0.017）,与术前测值相比差异无统计学意义（P>0.017）。 结论　CDFI可以观察并量化输尿管软镜碎石术围手术期肾内动脉灌注,快速评价术侧肾血流动力学变化,手术后会出现短期、可逆性肾叶间动脉流速减低、RI增高。     

超声诊断子宫内膜病变的应用价值

目的：研究子宫内膜病变经阴道超声诊断的应用效果。方法选择2014年4~7月我院妇产科收治的子宫内膜病变患者76例,将其经阴道超声检查跟病理诊断结果给予比较分析。结果与患者术后的病理诊断对比,经阴道超声诊断的总符合率是81.6%。经阴道超声诊断显示,子宫内膜良性病变血流显示率明显低于子宫内膜癌血流显示率(<0.01),且动脉阻力指数(RI)明显小于子宫内膜癌(P<0.05)。结论子宫内膜病变运用经阴道超声诊断的准确率比较高,可以清晰地显示出病变血流信号,临床诊断应用价值较高,值得进一步推广与应用。     

妊娠高血压晚期的血流频谱和围产期胎儿情况及血流阻力对孕妇妊娠结局的影响

目的探讨妊娠高血压(HDCP)晚期的血流频谱和围产期胎儿情况及血流阻力对孕妇妊娠结局的影响。方法选择2017年5至2019年6月在成都市双流区妇幼保健院收治的具有完整产检信息的50例妊娠晚期HDCP孕妇(观察组),年龄22～35岁,平均年龄29.2岁;体质量指数(BMI)29.3～36.5 kg/m~2,平均BMI 33.5 kg/m~2;舒张压13.1～14.7 kPa(98.5～110.4 mmHg),收缩压19.7～20.4 kPa(148.1～153.7 mmHg);孕周34～39周,平均孕周37.8周;20例妊娠期高血压,14例子痫前期,8例子痫,5例慢性高血压并发子痫前期,3例妊娠合并慢性高血压。以同期50例正常健康孕妇作为对照组,年龄23～36岁,平均年龄29.7岁;BMI 28.6～36.4 kg/m~2,平均BMI 33.1 kg/m~2。收集32周产检时两组孕妇彩色多普勒超声检测子宫动脉及脐动脉的阻力指数(RI)、血流搏动指数(PI)、收缩期峰值血流速度与舒张末期血流速度的比值(S/D)数据和出生后新生儿生长指标。比较两组孕妇子宫动脉及脐动脉血流阻力指标变化和出生后新生儿生长指标,观察两组新生儿1 min和5 min Apgar评分及妊娠结局。结果观察组子宫动脉及脐动脉多普勒血流频谱RI、PI、S/D指标均明显高于对照组(子宫动脉RI:0.60±0.21 vs 0.48±0.18;PI:1.22±0.31 vs 0.78±0.28;S/D:3.32±0.42 vs 2.78±0.38。脐动脉RI:0.71±0.18 vs 0.52±0.09;PI:1.30±0.28 vs 0.69±0.19;S/D:4.12±0.37 vs 2.80±0.27)。观察组胎儿生长发育受限,与对照组比较,差异均有统计学意义(P 0.05)。观察组新生儿1 min Apgar评分7分比例和5 min Apgar评分7分比例均高于对照组(46%vs 10%,24%vs 4%),差异有显著统计学意义(P 0.01)。观察组中子宫动脉和脐动脉高RI组孕周均明显短于低RI组;子宫动脉和脐动脉高RI组产后住院时间均明显长于低RI组[子宫动脉,(12±4) d vs (8±3) d。脐动脉,(11±5) d vs (7±4) d];子宫动脉和脐动脉高RI组行剖宫产的比例均明显多于低RI组(子宫动脉,51.4%vs 20.0%;脐动脉,54.1%vs 30.8%),差异有统计学意义(P 0.05)。结论子宫动脉多普勒血流频谱指标对预测HDCP孕妇妊娠结局具有一定的临床应用价值。     

彩色多普勒超声诊断子宫肉瘤的价值

目的 探讨彩色多普勒超声对子宫肉瘤的诊断与鉴别诊断的价值.方法 回顾性分析19例子宫肉瘤的声像图表现及多普勒血流频谱特点与手术及病理结果进行对照.结果 子宫肉瘤的二维声像图表现分为四类:子宫肌层实性占位(4例);子宫肌层囊实性占位(9例);子宫内膜占位(4例);宫颈占位(2例).血流特点是肿瘤表面和内部以血流丰富型为主(15/19),动脉阻力指数较低,15例RI平均值0.66.结论 子宫肉瘤的声像图和血流多普勒显示具有特征性表现,超声检查对子宫肉瘤的早期发现、早期诊断及鉴别诊断能为临床提供重要帮助.     

高频彩色多普勒超声在股前内侧穿支血管的检测及其临床应用评价

目的　探讨高频彩色多普勒超声在术前股前内侧穿支定位以及术后监测血流动力学指标中的应用价值。 方法　选择56例皮肤软组织缺损患者行穿支皮瓣修复术;采用高频彩色多普勒超声术前对股前内侧穿支进行探查,在术前和术后第1、3、5、7、14、30天的不同时间点测量穿支动脉的内径,血流量和血流动力学参数（Vmax,Vmin,PI和RI）。 结果　56例患者共检测到股动脉优势穿支动脉102支,股动脉穿支动脉Vmin,Vmax,血流量和内径在术后第1、3、5、7天逐渐上升,到术后第14、30天表现为下降,但均比术前升高,有统计学差异（P<0.05）;PI和RI在术后第1、3、5、7和14天逐渐降低,术后第30天略有上升,但均比术前降低,有统计学差异（P<0.05）。　结论　采用高频辨彩色多普勒超声探查可以直观显示股前内侧股动脉穿支血管的体表定位及血流动力学特点,有助于更好地指导皮瓣术前设计以及早期发现血管危险和评估预后。     

Colour Doppler assessment of ascendent uterine artery perfusion in an in-vitro fertilization-embryo transfer programme after pituitary desensitization and ovarian stimulation with human recombinant follicle stimulating hormone

The purpose of the present study was to evaluate the use of colour Doppler sonography of ascendent uterine artery perfusion in 91 patients undergoing in-vitro fertilization (IVF)-embryo transfer treatment after ovarian stimulation with a depot formulation of goserelin and recombinant human follicle stimulating hormone according to the long protocol. Resistance index (RI), pulsatility index (PI), maximum peak velocity (Vmax) and minimum diastolic velocity (Vmin) were assessed for the left and right ascending uterine artery on day 1 of ovarian stimulation, on day -2 [the day of human chorionic gonadotrophin (HCG) application] and on day +14 (12 days after embryo transfer). The data of 75 patients who had at least two cleaved preimplantation embryos available for transfer were analysed: 21 patients became pregnant resulting in a pregnancy rate of 28% (21/75). After exclusion of biochemical, ectopic and abortive pregnancies (n = 5), the data from 54 non-pregnant patients and 16 pregnant patients were analysed. No differences with respect to patient age, current cycle number, indication for IVF treatment, endometrial thickness at day -2 and serum oestradiol and serum progesterone concentrations at day -2 were found between the pregnant and non-pregnant groups. Compared to the non- pregnant patients the ascendent uterine artery flow of the pregnant patients showed significantly lower RI (P < 0.009) and PI (P < 0.03) values at the beginning of ovarian stimulation. Vmax and Vmin did not differ between the two groups. On day -2 no differences in RI, PI, Vmax and Vmin were found between pregnant and non-pregnant patients. On day +14 the flow in the ascendent uterine arteries of the pregnant patients showed significantly lower RI (P < 0.008) and PI (P < 0.03) values and significantly higher Vmax (P < 0.003) and Vmin (P < 0.0001) values. RI (P < 0.009) and PI (P < 0.003) values had decreased significantly and Vmax (P < 0.0002) and Vmin (P < 0.0001) had increased significantly on day +14 compared to the previous observation times in both the pregnant and non-pregnant groups. A significant correlation between the increase of serum progesterone concentrations and the decrease of RI (r = 0.68, P < 0.009), and the increase of Vmin (r = 0.67, P < 0.01) was only detected in the pregnant group. In conclusion, the differences found in RI and PI values at the beginning of ovarian stimulation were not clinically helpful as there was a wide overlap between non-pregnant and pregnant patients. The parameters currently used in colour Doppler assessment of uterine artery perfusion are not clinically helpful in discriminating prospectively which patients will and will not become pregnant in an IVF programme. In pregnant patients, increasing progesterone concentration is correlated with a significant decrease in impedance to uterine perfusion in the late luteal phase.      

The relationship between aldosterone to renin ratio and RI value of the uterine artery in the preeclamptic patient vs. normal pregnancy

PURPOSE: Plasma levels of renin, angiotensin II and aldosterone are increased during normal pregnancy. However, these values in preeclampsia are decreased to nearly that of a nonpregnant subject, and vascular sensitivity to angiotensin II is increased. In preeclampsia, aldosterone is decreased less than rennin. Therefore current studies were undertaken to determine the relationship between aldosterone to renin ratio (ARR) and uterine artery perfusion via RI value. MATERIALS AND METHODS: In this study, the relationship between plasma aldosterone and renin concentration was determined in 27 preeclamptic women and 50 normal pregnant women, whose gestational weeks were matched. The aldosterone to renin ratio was calculated and compared between the two groups. Doppler velocimetry of the uterine artery, which was used to calculate resistance index (RI), was performed on all subjects. The relationship between ARR and RI value was reviewed. RESULTS: In the preeclampsia group, RI value of the uterine artery was significantly higher than that of normal pregnant women. Both plasma renin and aldosterone concentrations were lower in the preeclampsia group. However, the ratio of these two parameters was significantly higher (38.3 vs. 16.1, p < 0.001); the greater ARR, the higher the RI of the uterine artery (r2 = 0.053, p = 0.048). CONCLUSION: This study demonstrates that a high aldosterone to renin ratio may have a negative effect on perfusion of the uterine artery and play an important role in the pathophysiology of preeclampsia.     

Raloxifene therapy does not affect uterine blood flow in postmenopausal women: a transvaginal Doppler study

OBJECTIVE: To monitor the effects of raloxifene therapy on the uterus of postmenopausal women by transvaginal ultrasonography and color flow Doppler. Methods: Twenty-five healthy postmenopausal women were enrolled in this prospective longitudinal study performed at Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeir?o Preto. The patients were treated with raloxifene hydrochloride (60 mg per day) for 6 months. All were submitted to transvaginal ultrasound examination with color flow Doppler (ATL-HDI 3000 equipment) before the beginning and after 1, 3 and 6 months of treatment. Resistance index (RI) and pulsatility index (PI) of the uterine arteries were determined by the Doppler method, being considered as indicators of uterine perfusion. The following variables were analyzed: endometrial thickness, uterine volume, RI, and PI. Data were analyzed statistically by repeated-measures analysis of variance. RESULTS: Before treatment, endometrial thickness was 3.38 +/- 0.73 mm, and similar values were observed after 1, 3 and 6 months of treatment (3.04 +/- 0.82; 3.3 +/- 0.83; and 3.37 +/- 0.79, respectively) (P > 0.05). No significant differences in uterine volume were observed between the pre- and post-treatment periods. Uterine artery perfusion as indicated by RI and PI measured by Doppler also showed no significant variation, with a high impedance flow being maintained throughout treatment. CONCLUSIONS: In the group studied here, raloxifene treatment at the dose of 60 mg per day for 6 months did not induce significant changes in endometrial thickness, uterine volume or uterine artery perfusion, confirming that short-term raloxifene treatment does not affect the uterus of postmenopausal women.     

Renal blood flow in twins

The aim of this preliminary study was the estimation of renal blood flow in 16 premature newborns from twin pregnancies with mean body weight 1270 g and mean gestational age 29 weeks. In control group we have 16 singleton newborns with mean gestational age 29 weeks and mean birth weight 1240 g. In both intervention and control group we have the similar clinical symptoms. The renal blood flow was carried out in the first day of life with the Acuson 128 XP Colour Doppler using the 6 and 7 MHz linear transducer. The renal blood flow parameters-PI, RI, Vmax, Vmin Vmean were measured in right and left renal arteries in theirs courses from the aorta to the renal hilus, by color sinal. In the investigation group the mean value of RI in right and left renal artery was 0.88. Mean PI in right vessel was 1.67 and in left 1.56. Mean V min in right and in left artery was 0.03 and mean V max in right artery was 0.34 and in left 0.33. Mean value of mean velocity in right vessels was 0.18 and in left 0.19. In control group we observed in right artery mean value of PI 1.74 and in left 1.6. Mean RI was 0.86 and 0.86 in right vessel in left vessel. Mean V min was 0.05 in right and 0.04 in left artery. Mean V max was 0.37 in right and 0.34 in left artery. Mean value of V mean was 0.19 in right artery and 0.18 in left artery. Using the student, Mann-Whitney and Shapiro-Wilk tests we have not observed statistically significant difference of Doppler parameters between control and investigation group and between the left and right artery. Although in newborns with broad PDA we noted significant higher value of RI (0.97, 0.98) than in newborns without PDA (0.78, 0.81).     

Umbilical and uterine artery flow velocity waveforms in pregnant women with systemic lupus erythematosus treated with aspirin and glucocorticosteroids.

Pregnancy in systemic lupus erythematosus (SLE) is at high risk to the mother and fetus. Impaired utero-placental perfusion may increase fetal loss and intrauterine growth retardation. We assessed the changes in impedance to blood flow in the umbilical and uterine arteries in five patients with SLE treated with low dose aspirin and corticosteroids, using Doppler ultrasound longitudinally throughout pregnancy. Blood flow velocity waveforms of the umbilical and uterine arteries were studied by transabdominal and transvaginal Doppler ultrasound, respectively. Resistance index (RI) was measured every two to four weeks from week 10 to term, and the values obtained were compared to those of normal pregnancies. All five patients delivered uneventfully. One neonate was delivered at 36 weeks (2550 g) and one neonate was growth retarded (1900 g at 38 weeks). Three women delivered at 39 weeks (3585 g, 2850 g, and 2800 g). Most umbilical artery RI values obtained throughout pregnancy were above the 95th percentile of normal pregnancies. The highest values of RI of the umbilical artery were assessed in the case of fetal growth retardation. However, most measurements of RI of the uterine artery were under the 95th percentile of normal. The improved pregnancy outcome in patients with SLE treated with aspirin and corticosteroids seems to correlate with their normal uterine artery flow velocity wave forms.     

Different changes in resistance index between uterine artery and uterine radial artery during early pregnancy

BACKGROUND: Changes in blood flow impedance of the uterine artery (UA) and uterine radial artery (RA) which is in the lower-extremity of the UA were examined during early pregnancy. METHODS: Blood flow impedance was assessed by transvaginal color-pulsed-Doppler-ultrasonography in 72 women from weeks 4-16 of pregnancy and expressed as a resistance index (RI). RESULTS: RA-RI remained at the late-luteal phase level until the 5th week of pregnancy, decreased until the 7th week, and remained low until the 10th week. UA-RI remained at the late-luteal phase level until the 10th week, and then gradually decreased until the 16th week. In nine women with spontaneous abortion, five out of six women with impaired growth of the gestational sac showed high RA-RI at the 6th week of pregnancy, whereas all three women with loss of fetal heart beat at the 8th week showed normal changes in RA-RI. CONCLUSIONS: Our results show different changes in blood flow impedance between the UA and RA during early pregnancy. A significant decrease of RA-RI after the 5th week may reflect vascular remodeling in the maternal-fetal interface at placentation, whereas a significant decrease of UA-RI after the 10th week may reflect changes of the whole uterine blood flow associated with uterine growth.     

血清和肽素联合子宫动脉血流参数对子痫前期的早期筛查价值分析

目的探讨血清和肽素(CPT)联合子宫动脉血流参数对子痫前期(PE)的早期筛查价值。方法前瞻性随机选取2018年4月至2019年5月期间在我院行孕检的孕妇504例作为研究对象,所有孕妇均随访至分娩,并根据在孕期是否发生PE进行分组,将其中发生PE的38例孕妇纳入PE组,其余466例孕妇纳入对照组。于孕20~24周时采用酶联免疫吸附法检测所有研究对象血清CPT的水平,采用彩色多普勒超声诊断仪检测血流搏动指数(PI)、子宫动脉收缩期与舒张期血流速度比值(S/D)、阻力指数(RI)。结果PE组的S/D、PI、RI及血清CPT均明显高于对照组,差异均有统计学意义(P<0.05),经Pearson分析显示,PE患者血清CPT与舒张压、收缩压、S/D、PI、RI均呈正相关(P<0.05),ROC曲线分析显示,血清CPT对PE的预测价值较高,曲线下面积为0.797,而各项子宫动脉血流参数对PE亦有一定的预测价值,其中PI的预测价值最高,曲线下面积为0.813。血清CPT联合PI可明显提高预测价值,其灵敏度为84.21%、特异性为83.91%,约登指数为0.681。结论血清CPT和各项子宫动脉血流参数对PE的早期筛查有一定的临床应用价值,且血清CPT联合PI可明显提高预测价值。