颈动脉炎的彩色多普勒超声检查

颈动脉炎是一种较严重的血管疾病,早期不易确诊。超声对本病的早期诊断及病程观察有着较明显的优势。现将2005年我院6例颈动脉炎彩色多普勒诊断经验报告如下。1材料与方法1.1临床表现本组6例,男1例,女5例,年龄21~36岁,平均29岁。5例因四肢单肢弱脉或无脉症,其中2例伴视力障碍,1例因头痛头晕和有不同程度的关节痛、肌痛、发热等非特异性症状。1.2检查方法应用GE-VIVID 7型彩色多普勒超声诊断仪,探头频率为7~11MHz,患者取仰卧位充分暴露颈部,于颈动脉走行区域纵横位扫查。2结果双侧颈动脉病变者5例,其中1例右侧颈动脉管腔完全闭塞,腔内无…     

Contrast-enhanced color Doppler ultrasonography in suspected parathyroid lesions

Purpose: To assess the usefulness of US contrast media in the evaluation of patients with primary hyperparathyroidism, with a nodule showing US features of a primary parathyroid lesion but lacking the color Doppler US appearance of a parathyroid mass.Material and Methods: Thirteen patients (7 female, 6 male; age range 51-79 years) were examined with US before and after administration of a stabilized galactose-based microbubble contrast agent. Ten patients underwent surgery and the final histological examination demonstrated parathyroid adenoma in 9 cases and a mesenchymal benign nodule in 1 case. Three nodules were proved to be of thyroid origin at fine-needle aspiration biopsy.Results and Conclusion: The use of a US contrast agent resulted in a diagnostic gain compared to unenhanced studies in 12/13 cases. Color Doppler findings characteristic of parathyroid lesions were observed in 7/13 cases, of thyroid nodules in 4/13 cases, and nonspecific patterns in 2/13 cases. Contrast-enhanced color Doppler US can be proposed in selected patients in whom unenhanced color Doppler provides uncertain findings. Its ideal application should be the evaluation of cervical lesions without detectable intranodular flow at unenhanced Doppler studies. In these cases, the contrast agent helps in visualizing typical color Doppler signals of the parathyroid lesions ("vascular pole" and "mixed pattern").     

彩色多普勒超声对颈动脉体瘤的诊断价值

 目的 探讨彩色多普勒超声在颈动脉体瘤诊断中的应用价值.方法 回顾性分析7例颈动脉体瘤患者的二维及彩色多普勒超声表现.所有病例均经手术病理证实.结果 颈动脉体瘤二维超声表现为颈动脉分叉处见实质性低回声肿块,边界清晰,边缘规则或呈分叶状.肿瘤较小时,多位于颈总动脉分叉处,使颈内、外动脉间距增大,形状多较规则;肿瘤较大时,常围绕血管生长.彩色多普勒超声均可见肿瘤内有较丰富的彩色血流信号,以动脉血流为主;CDFI还能清晰显示肿瘤与颈动脉的关系.结论 二维及彩色多普勒超声对诊断颈动脉体瘤具有无创、安全、特异性、准确性高的特点,有利于同颈部其他性质包块的鉴别诊断,是目前颈动脉体瘤诊断的首选方法.     

彩色多普勒超声对颈动脉-海绵窦瘘的诊断价值

目的探讨彩色多普勒超声（CDUS）对颈动脉-海绵窦瘘（CCF）的诊断价值。方法本文应用CDUS对6例CCF患者进行了分析,并与脑血管造影比较。结果CDUS显示,引流静脉多以扩张的眼上静脉为主,脉冲多普勒可测到连续层流的静脉频谱中混叠有动脉搏动性频谱,患侧颈内动脉流速明显高于健侧;患侧大脑中动脉（MCA）、大脑前动脉（ACA）流速低于健侧。压迫患侧颈总动脉,患侧颈内动脉（瘘口以上）出现不同程度的倒灌血流。结论彩色多普勒超声对颈动脉-海绵窦瘘的诊断具有高度的特异性,是一项值得临床推广应用的无创、方便、快捷的诊断颈动脉-海绵窦瘘的辅助检查方法。     

彩色多普勒超声在颈动脉粥样硬化诊断中的应用

目的和方法 对60例分别有高血压(26例)、冠心病(20例)、脑梗塞(10例，其中高血压、冠心病合并脑梗塞8例)，脑供血不足(4例)患做颈动脉超声检查，探讨彩色多普勒超声在颈动脉粥样硬化(CAS)诊断中的应用价值。结果 60例患均有程度不等的颈动脉粥样硬化形成，其中16例为单纯内膜一中层厚度增厚，44例有粥样硬化斑块形成，占73．3％。CAS斑块好发于颈总动脉分叉处，以扁平斑多见，软斑、硬斑次之，溃疡斑最少。结论 彩色多普勒超声检测颈动脉粥样硬化有重要的临床应用价值。     

彩超对颈动脉粥样硬化与慢性脑供血不足相关性的研究

目的:研究颈动脉粥样硬化与慢性脑供血不足(chronic cerebral circulation insufficiency,CCCI)的关系。方法:应用彩色多普勒超声对86例确诊为CCCI患者的颈动脉进行血管内径测量,内膜-中膜厚度(intima-medial thickness,IMT)测量,观察有无斑块形成和血管狭窄情况。结果:86例CCCI患者中,有颈动脉硬化(IMT增厚和斑块形成)78例,检出率达90.7%,其中IMT增厚达29.1%,斑块形成达61.6%。结论:CCCI与颈动粥样硬化存在着线性关系,早期检测颈动脉粥样硬化可预CCCI的发病,提高早期诊治率,减少缺血性脑血管病的发生。     

颈动脉体瘤超声表现1例报告

患者,女,31岁,自觉左颈部包块就诊。彩色多普勒超声检查:左侧颈部颈总动脉分叉处见一大小约2.6 cm×2.3 cm低回声团块,致颈内、外动脉间距增宽,团块形态较规则,边界清晰,内部回声不均质,中央可见管状暗区,管腔内未见异常回声充填。彩色多普勒血流显像(CDFI)示:团块内见丰富的血流信号,探及低速低阻动脉频谱(见图1)。中央见颈外动     

Hepatic focal lesions: role of color Doppler ultrasonography with contrast media

INTRODUCTION: The differential diagnosis of focal hepatic lesions is still studied by diagnostic imaging operators. A big step forward in the field of ultrasound (US) has come from the color Doppler mode permitting accurate studies of the vascularization of focal hepatic lesions. Echocontrast agents have further improved color Doppler sensitivity to slow flows and have permitted to visualize intralesional vascular signals which were missed at B-mode US. New data have thus been acquired which can be integrated with flowmetric findings to help make the correct differential diagnosis with a fair safety margin. We studied the pathognomonic US pattern for each type of lesion. MATERIAL AND METHODS: We examined 55 patients with single hepatic lesions which had already been typified: they were 10 hepatic angiomas, 3 focal nodular hyperplasias (FNH), 2 hepatic adenomas, 20 hepatocarcinomas and 20 hepatic metastases. Color Doppler investigations were performed on each patient before and after the intravenous (i.v.) administration of an echocontrast agent (Levovist, Schering AG, Berlin, Germany). For each lesion we studied the morphological characteristics, the resistance index (RI) of intralesional arterial vessels, the hepatic perfusion index and the maximum speed in intralesional vessels. RESULTS: Contrast-enhanced US showed no intralesional signals or afferent branches in 8 hepatic angiomas, which however exhibited some peripheral vascularization; weak intralesional vascular signals were demonstrated in 2 cavernous angiomas. Intralesional signals, as well as peripheral vascularization, were detected in the 3 FNH cases, which also exhibited a centripetal afferent branch; the hepatic perfusion index in these lesions never exceeded .25. The two hepatic adenomas had similar color flowmetry to FNH also after i.v. contrast agent administration, except for the contripetal afferent vessel which was not seen. In the 20 hepatocarcinomas, contrast-enhanced images showed numerous intralesional signals and afferent branches which, with the peripheral vascularization, resulted in a basket-like pattern. Flowmetry of intralesional arterial vessels showed an irregular systodiastolic range, with RI = .32 +/- .5 in 12 lesions and high in the remaining 8 lesions (RI = .82 +/- 10). The hepatic perfusion index was .65 +/- 10 in all patients. In 14 of the 20 hepatic metastases, B-mode US showed no intralesional signals except for 6 metastases from colorectal carcinoma, and contrast-enhanced findings were about the same. The hepatic perfusion index at flowmetry ranged .30 to .45 in all patients.     

彩超在喉部良性占位性病变诊断中的应用价值

目的:评价彩超对喉良性占位性病变的诊断价值。方法:对59例喉良性病变住院病人术前行彩色超声检查并与喉内镜及手术、病理对照。结果:彩超对声带息肉的检出率为100%,能较清晰显示喉部良性病变的大小、部位、内部回声及血流情况、病变范围及其与声带边缘的关系。结论:彩超对喉部良性病变有较高的诊断符合率,特别是对难以配合的儿童患者及其他常规检查难以配合的患者则是最佳检查方法,对临床选择喉显微手术方式具有指导意义。但是要求操作者必须手法娴熟且熟悉喉部解剖。     

彩色多普勒超声在乳腺恶性病变诊断中的临床应用价值

近年来,乳腺恶性病变的发病率呈现逐年上升趋势,且发病有趋于年轻化的走势[1].有文献报道[2],在发达国家中,所有女性致死恶性肿瘤中,乳腺癌已跃居首位.大量研究表明,早期诊断而采取有效的治疗是提高乳腺恶性病变患者生活质量和生存率的关键[3].因而对乳腺癌的早期诊断与治疗已成为一个焦点.与乳腺钼靶X线检查相比,超声检查不但可避免电离辐射并在对乳腺内部的微细结构的显示和肿块的性质的鉴别方面更具有优势,诊断数据丰富,更利于临床应用.     

The so-called atheromatous pseudoocclusion of the internal carotid artery

The term "atheromatous pseudoocclusion" of the internal carotid artery (ICA) describes an extreme type of stenosing lesion which, during non-invasive procedure and conventional angiography is easily misdiagnosed as complete occlusion. Its recognition requires special sonographic and angiographic techniques. Nine subjects with pseudoocclusion could be observed during the last 12 months, most of them presenting minor strokes. Infarction suggesting a haemodynamic pathogenesis were demonstrated in seven of the cases by computed tomography. In seven of the eight subjects that were operated on, ICA reconstruction was successful. Since pseudoocclusion of the ICA is likely to progress rapidly to definite occlusion, the patient is severely jeopardized from periocclusive embolism into the major brain arteries. Immediate diagnostic clarification and emergency endarterectomy are mandatory.     

Application of Doppler ultrasonography in congenital vascular lesions of the head and neck.

OBJECTIVES: To evaluate the value of Doppler ultrasonography in the assessment of congenital vascular lesions of the maxillofacial region. METHODS: 27 new patients with 36 congenital vascular lesions in the maxillofacial region as well as 10 patients previously treated with cryotherapy underwent ultrasonography (US) with a 6.0-10.0 MHz broadband linear transducer (reference Doppler frequency 7.5 MHz). Initial grey-scale US was followed by Color Doppler, Power Doppler and spectral Doppler studies. The presence or absence of flow was noted. In areas of high vascularity the number of vessels within a 1 cm(2) restricted region of interest were increased by spectral Doppler. RESULTS: US allowed differentiation of seven hemangiomas from other congenital vascular lesions and thus appropriate treatment of patients. Low flow vessels were demonstrated within the scars of five lesions previously treated with cryotherapy, requiring further intervention. CONCLUSION: Doppler US is a widely available, non-invasive and relatively inexpensive technique which can be used to characterize the flow of head and neck vascular anomalies and thus differentiate hemangiomas from other vascular malformations.     

Diagnosis of thyroid nodules by Doppler ultrasonography: a comparison between color Doppler and power Doppler ultrasonography

The purpose of this study was to assess the usefulness of color and power Doppler imaging in thyroid nodules. The following 4 items were compared between malignant thyroid nodules (34 cases) and benign nodules (51 cases): 1) vascularity; 2) distribution of tumor vessels (none, marginal, peripheral, central); 3) nature of tumor vessels (tortuosity, interruption); and 4) FFT analysis. The distribution of tumor vessels on color Doppler images, nature of tumor vessels on power Doppler images, and the indices of PI, RI, and ATI in FFT analysis were useful in making the differential diagnosis between malignant and benign nodules. In terms of vascularity, including the distribution of tumor vessels on power Doppler images and nature of tumor vessels on color Doppler images, no statistically significant differences were found between malignant and benign nodules. Power Doppler images depicted tumor vessels in more detail than color Doppler images and were considered to extend the application of FFT analysis.     

彩色多普勒超声在脑梗死患者颈动脉粥样硬化诊断中的应用

目的 初步探讨脑梗死患者颈动脉硬化病变的超声影像特点。方法 应用彩色多普勒超声对55例临床上确诊的脑梗死患者和58例正常对照组行颈动脉检测。结果 脑梗死组颈动脉粥样硬化及斑块发生率(74．5％)明显高于对照组(15．5％)，且随年龄增长呈上升趋势。动脉硬化斑块发生部位以颈动脉分叉部多见(50．4％)。在斑块的4种超声分型中，以扁平斑和软斑发生率为高。结论 超声检测颈动脉粥样硬化对预测和治疗脑梗死有重要的临床意义。     

彩色多普勒超声检查颈动脉硬化患者椎动脉供血不足的价值

<正> 颈动脉硬化患者可表现出椎-基底动脉供血不足造成的一过性头晕,我们用彩色多普勒超声方法,对颈动脉硬化椎-基底动脉供血不足患者进行颅外段的椎动脉检查,通过声像图及其血流动力学参数的改变观察其变化。1资料与方法1.1一般资料收集2004～2008年我院住院及门诊100例颈动脉硬化患者,临床无耳科及眼科疾病