子宫动静脉畸形的彩超诊断1例分析

患者女，31岁。因引产后阴道不规则出血20天，临床以阴道出血查因(胎盘胎膜残留？绒癌待排)入院。患者因怀孕4月余曾行药物引产，死婴娩出时出血量多，经处理后，阴道出血如月经量，约半月后无明显诱因又出现阴道出血量增多．即到民营诊所行清宫术，因出血不止而行清宫术，手术顺利未清出明显胚胎残留物，术后给予抗炎治疗。     

胎儿多发畸形1例

患者女,32岁,G2P0 2.因"停经5 月,外院超声检查发现胎儿异常"来我院就诊.当日患者作彩超检查发现 :胎儿双顶径:5.3 cm,股骨长:3.6 cm,羊水:5.4 cm,胎盘前壁2.4 cm,0级,胎儿左侧侧脑室扩张1.3 cm,脑室率大于0.5,双侧侧脑室脉络膜囊肿,直径0.6 cm,骶尾部查见2.3 cm×2.6 cm×2.6 cm囊性占位,右上肢未查见桡骨图像,双手内翻.超声诊断为:①宫内活胎;②胎儿侧脑室扩张;③双侧侧脑室脉络膜囊肿(图1);④胎儿骶尾部脊膜膨出(图2);⑤右上肢桡骨缺失,双手内翻(图3).经引产后证实:胎儿双手内翻,骶尾部脊膜膨出,唇腭裂,双耳位于下颌.X线检查示右上肢桡骨缺失.     

彩色多普勒诊断肾动静脉瘘1例

1病例报告男,50岁。因左侧腰部不适2个月就诊,查尿常规潜血(+),超声检查示双侧肾脏形态体积正常,实质回声均匀,于左肾下极内见一约20 mm×19 mm无回声区,形态规则,CDF I示无回声区内充满花色血流信号,明暗相间,为五彩镶嵌的湍流。脉冲多普勒可引出动静脉血流信号混叠在一起。超声诊断:左肾动静脉瘘。2讨论肾动静脉瘘分为先天性、获得性和特发性三类。先天性动静脉瘘少见,实为动静脉畸形;特发性也称为自然性动静脉瘘;获得性动静脉瘘的原因很多,如肾手术后、肾创伤后、肾脏穿刺活检后、肾内炎症等疾病均可形成肾动静脉瘘。肾动静脉瘘所造成…     

超声诊断子宫动静脉瘘1例

病例女,49岁,因健康查体行经阴道彩超,声像图见:子宫大小形态正常,肌层回声不均,近内膜处肌层内可见囊状及扭曲管状无回声,另宫腔内见节育环影.彩色及脉冲多普勒检查证实为增宽的动脉及静脉血管.彩色多普勒检查局部血流混叠呈五彩镶嵌血流信号,频谱多普勒呈双相、带搏动性混合频谱.超声诊断:子宫动静脉瘘可能.     

超声诊断小儿头皮血管畸形与颅内上矢状窦相通1例

病例 男．36个月。发现头顶部异物逐渐增大伴波动感15个月。超声表现：于患儿头顶部头皮内可探及一大小约为2．5cm×2．0cm的囊性包块,该包块位于上二矢状缝上方,并可见一管状无回声经上矢状缝向颅内延伸与上矢状窦相通。仔细探查包块周边,可见4条管状无回声与囊性包块相连。     

脑动静脉畸形DSA形态与其出血预测

目的探讨脑动静脉畸形(AVM)出血与脑AVM大小及引流静脉数目的相关性.方法回顾性分析109例数字减影脑血管畸形造影资料.结果大型脑AVM出血率明显低于小型脑AVM的出血率(P<0.01);1支引流静脉出血者明显多于3支以上引流静脉出血者(P<0.01);引流静脉通畅者其出血率低.结论通过观察脑AVM的大小、引流静脉的数目以及引流静脉的通畅情况,可对脑AVM的出血进行预测.     

后天性肢体动静脉瘘治疗前后超声评价

目的探讨后天性肢体动静脉瘘(AVF)治疗前后彩色多普勒超声评价的临床价值。方法后天性AVF患者治疗前行超声及数字减影血管造影术(DSA)检查,依据超声及DSA检查结果分别对AVF瘘口分型,治疗后应用彩色多普勒超声复查并进行评价。结果本组AVF共31例,其中腋动脉1例、肱动脉3例、桡动脉3例、尺动脉1例、掌动脉2例,股总动脉9例、股浅动脉6例、腘动脉3例、胫前动脉2例、胫后动脉1例;所有病例均只有1个瘘口。二维超声显示24例瘘口内径为2~6 mm,平均(3.9±2.6)mm,7例在二维图像上未见到明显瘘口,但瘘口近端动静脉均有扩张。二维图像上显示12例见瘘口、瘘管及其旁血管呈动脉瘤或假性动脉瘤样改变。本研究中所有病例彩色多普勒超声均显示出动静脉间有异常分流血流信号,根据彩色多普勒超声结果分型:Ⅰ型10例,Ⅱ型9例,Ⅲ型12例,其中Ⅲa型3例、Ⅲb型7例、Ⅲc型2例。超声检查和术前或术中DSA对肢体AVF分型一致性很好(Kappa=0.957)。9例超声引导下弹力绷带局部加压包扎法保守治疗,10例介入治疗,12例手术切开治疗,多次复查彩色多普勒超声未见明显分流血流信号,提示瘘口闭合,治疗效果良好。结论彩色多普勒超声对后天性肢体AVF的诊断、分型及疗效评价有较好的应用价值,可作为首选及必要的影像学方法。     

彩色多普勒超声诊断子宫动静脉畸形

子宫动静脉畸形 (ａｒｔｅｒｉｏｖｅｎｏｕｓｍａｌｆｏｒｍａｔｉｏｎｓ ,ＡＶＭｓ)是较为罕见的妇科疾病 ,本研究应用超声观察 7例ＡＶＭｓ患者 ,旨在探讨其超声特征性表现及临床应用价值。资料与方法1996年 6月至 2 0 0 1年 6月我院诊断ＡＶＭｓ 7例 ,年龄 2 0～ 45岁 ,平均 3 2 .5岁 ,经产妇 2例 ,未产妇 5例 ,既往接受过刮宫术者 4例。就诊原因 :阴道流血 5例 ,其中 1例因清宫术后阴道流血加重 ,不孕症 1例 ,体检发现 1例。应用ＡＴＬＨＤＩ3 0 0 0型彩色多普勒超声诊断仪 ,频宽 2～ 5ＭＨｚ经腹凸阵探头和 5～ 9ＭＨｚ腔内探头经阴道…     

Nontumorous vascular malformations in the liver: color Doppler ultrasonographic findings.

OBJECTIVE: To investigate color Doppler and spectral wave characteristics of nontumorous vascular malformations in the liver. METHODS: From September 1995 to January 2001, 32 cases of vascular malformations were identified by means of color Doppler ultrasonography and spectral wave analysis. Computed tomography, angiography, or both were performed in all cases. RESULTS: Five arterioportal and 14 portovenous malformations, 1 arteriovenous malformation, and 4 portoportal and 8 venovenous shunts were detected. Associations with Rendu-Osler-Weber syndrome in 6 cases and with cirrhotic liver in 12 cases were found Fourteen patients were liver disease free. In 3 cases, interventional procedures were necessary to reduce portal hypertension or cardiac dysfunction. The incidence of finding vascular malformations in 12,000 patients was 0.1%. CONCLUSIONS: Nontumorous vascular malformations are rare disorders in the liver. They may appear in patients with healthy livers and in patients with portal hypertension. Color Doppler ultrasonography and spectral wave analysis are capable of showing and differentiating different types of hepatic vascular malformations.     

Intrarenal arteriovenous fistula causing a "pseudonutcracker effect"

We report a case in which an intrarenal arteriovenous fistula caused the nutcracker effect. Color Doppler sonography of the left renal artery showed a peak systolic velocity of 150 cm/second and renoaortic ratio of 2.1. The left renal vein was significantly dilated, and the adjacent renal artery was kinked. A stenosis in the left renal vein at the aorto-mesenteric bifurcation was demonstrated, with a maximum velocity of 201 cm/second. Renal Doppler evaluation showed an area of high-velocity, low-resistance arterial flow consistent with an arteriovenous fistula in the inferior half of the left kidney. Angiography confirmed the fistula. The fistula was successfully occluded by coil embolization. Follow-up sonography showed almost complete obliteration of the fistula, regression of the renal vein dilatation, and a reduction in renal venous and arterial flow velocities. Given the reversibility of the fistula's effects, we suggest the term "pseudonutcracker effect" to describe this case.     

Sonographic appearance of congenital arteriovenous fistula of the hand

Congenital arteriovenous fistula of the hand is uncommon. We report a case of unusual congenital arteriovenous fistula forming multiple fistulous communications between the arteries and veins in the right hand. Clinical findings were confirmed by color Doppler sonography and digital subtraction angiography.     

Renal arteriovenous malformation mimicking hydronephrosis

Color and spectral Doppler sonography revealed that a patient believed to have hydronephrosis actually had a renal arteriovenous malformation. Although rare, such a misdiagnosis could have serious implications. In the case described here, there was a coexisting carcinoma of the colon, which required staging and could have led to complications for percutaneous intervention. This case illustrates that color Doppler sonography can be used to establish a diagnosis of arteriovenous malformation. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26 : 95–97, 1998.     

Posterior mediastinal arteriovenous malformation with atypical color Doppler sonographic findings

An arteriovenous malformation (AVM) is an anomaly of capillary development that results in a direct connection between branches of an artery and veins, with no intervening capillary network. A definite diagnosis of AVM is usually made with angiography. We report the case of a posterior mediastinal AVM found on routine sonography in a 64-year-old woman with neglected hypertension and severe back pain. Color Doppler imaging showed 2 adjoined vascular structures without a typical mosaic-like flow pattern, and spectral Doppler analysis showed low-resistance flow and arteriovenous shunting in 2 adjoined vascular structures. The diagnosis was subsequently confirmed by angiography. Because disastrous bleeding could result if needle biopsy were performed inadvertently in the case of a suspected mediastinal AVM, we suggest that color Doppler sonography be attempted if there is an adequate acoustic window.     

超声诊断孤立性右锁骨下动脉合并B型主动脉弓离断1例

患儿男,出生2天,呼吸急促4 h;孕龄39周+4时因\"母体胎盘早剥急性出血\"经剖宫产娩出,出生体质量2.7 kg,Apgar评分9分、出生后5 min评分10分;外院产前检查未见异常.查体:血氧饱和度83％,左上肢血压75/50 mmHg,右上肢血压70/45 mmHg,双下肢血压均为65/40 mmHg.彩色多普勒超...     

经颅彩色多普勒超声及经颅超声造影在颅内动静脉畸形中的应用

目的探讨经颅彩色多普勒超声(TCCS)及经颅超声造影(CE-TCCS)在颅内动静脉畸形诊断中的应用价值。方法对31例疑为颅内动静脉畸形的患者分别行经颅彩色多普勒超声及经颅超声造影检查,比较造影前后畸形血管团及供血动脉的显示率,并与数字减影血管造影(DSA)或计算机体层摄影血管成像(CTA)检查结果进行对比。结果 (1)经CTA或DSA证实30例为颅内动静脉畸形,1例为颅内海绵状血管瘤。(2)经颅彩色多普勒超声对颅内动静脉畸形的显示率为70%(21/30),经颅超声造影对颅内动静脉畸形的显示率为96.7%(29/30)。对位于颞叶(11例)、岛叶(1例)、小脑(1例)的颅内动静脉畸形经颅彩色多普勒超声测量动静脉畸形血管团大小与DSA测量结果一致,而5例位于额叶、1例位于顶叶及1例位于枕叶的动静脉畸形血管团测值(2.4cm×3.0cm)明显小于DSA测值(3.0cm×3.6cm)。经颅超声造影测量畸形血管团的大小均与DSA测值一致(3.5cm×4.4cm)。(3)经颅彩色多普勒超声对供血动脉的显示率为59.5%(22/37),经颅超声造影对供血动脉的显示率为83.7%(31/37),造影后供血动脉流速较造影前略增快,但造影前后收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)测值比较差异无统计学意义(P0.05)。结论经颅超声造影可提高颅内动静脉畸形及供血动脉的显示率,经颅超声造影测量畸形血管团大小与DSA检查结果更为一致。     

胃十二指肠动脉瘤彩色多普勒超声表现1例

胃十二指肠动脉瘤(Gastroduodenal artery aneurysm,GDAA)是罕见的内脏动脉瘤,约占全部内脏动脉瘤的1.5%,多由其他原因进行放射影像学检查时偶然发现,目前国内几乎未见彩色多普勒超声报道。     

Color Doppler sonographic diagnosis of dissecting aneurysm of the superior mesenteric artery

We report a case of dissecting aneurysm of the superior mesenteric artery (SMA) diagnosed on gray-scale and color Doppler sonography and confirmed on angiography. Spontaneous dissection of the SMA is rare, and there are few reported cases of the color Doppler sonographic findings. Gray-scale sonography revealed an aneurysmal dilatation of the SMA 3-4 cm from the SMA's origin, with an echogenic linear membrane (an intimal flap) within the aneurysm. Color Doppler sonography showed color flow within the aneurysm and showed that the intimal flap separated the aneurysm into 2 lumina. Spectral analysis revealed anterograde flow in the anterior (ie, true) lumen and retrograde flow in the posterior (ie, false) lumen.     

Diagnosis of arteriovenous malformation of the internal iliac vessels by color Doppler ultrasonography: A case report

A 13-year-old girl was admitted to the hospital because of cardiomegaly found incidentally at regular medical checkup at her school. Although dilated cardiomyopathy was suspected, the girl showed no symptoms. chest x-ray film showed cardiomegaly (cardiothoracic ratio, 67%), and echocardiogram demonstrated a dilatation of the left ventricle without thinning of the wall. While contraction was diffusely decreased, estimated cardiac output was increased to 13l/minute. Abdominal ultrasonography conducted to clarify the cause of this high output showed a multicystic lesion (8×6×4 cm) at the back of the left common iliac artery. Color Doppler ultrasonography revealed abundant blood flow within the lesion, establishing the diagnosis of arteriovenous malformation. Aortography delineated the arteriovenous malformation being supplied from the left internal iliac artery and from the left third and fourth lumbar arteries and drainage into the left common iliac vein and the right internal iliac vein. Although it did not show the precise location of the feeding and draining vessels, color Doppler ultrasonography was useful for the diagnosis of arteriovenous malformation.