Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre-eclampsia.

OBJECTIVES: To evaluate the performance of velocimetric indices of uterine artery flow velocity waveforms (FVW's) at 20 weeks' gestation, alone or in combination with qualitative analysis, and establish the optimal screening method for the prediction of pre-eclampsia. METHODS: A total of 614 primiparous women had color flow/pulsed Doppler (CFPD) imaging of both uterine arteries at 20 weeks gestation. Receiver operator characteristic (ROC) curves were created for the systolic/end-diastolic (A/B) ratio, resistance index (RI) and systolic/early diastolic (A/C) ratio for placental and non-placental uterine arteries, individually or in combination with the presence of unilateral or bilateral notches. Based on data from ROC curves, the sensitivity of each method was compared with the false-positive rate set at 17 and 11%. RESULTS: The highest sensitivity (88%) and specificity of (83%) was obtained using bilateral notches/mean RI > or = 0.55 (50th centile) and unilateral notches/mean RI > or = 0.65 (80th centile). When the false-positive rate was set at 17%, the inclusion of bilateral notches significantly improved the sensitivity of RI (P < 0.001), placental RI (P < 0.01), placental A/C ratio (P < 0.05), mean A/C ratio (P < 0.01) and mean A/B ratio (P < 0.05). Bilateral notches/mean RI or A/B cut-offs were also superior to the persistence of a notch in either artery combined with RI (P < 0.01) or A/B ratio (P < 0.05). When the false-positive rate was set at 11%, the inclusion of bilateral notches did not improve the sensitivity of the A/C (P = 1.00) or A/B ratio (P > 0.10). Placental velocimetric indices performed better than mean indices but the differences in sensitivity at the set false-positive rates were not statistically significant. CONCLUSION: At 20 weeks' gestation, bilateral notches with mean RI cut-offs is the best screening method if further screening later in pregnancy is proposed. The A/C ratio is complementary to bilateral notches when the false-positive rate is set at 17% and an effective quantitative substitute when the false-positive rate is set at 11%.     

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.     

Smoking prevents the expected postprandial increase in intestinal blood flow: a Doppler sonographic study.

OBJECTIVE: To assess whether cigarette smoking had an effect on superior mesenteric artery postprandial blood flow. METHODS: Forty-six subjects were studied in 3 groups with Doppler sonography. Group A consisted of nonsmokers; groups B and C consisted of smokers. In group B, subjects were allowed to smoke cigarettes postprandially, whereas in group C, postprandial smoking was prohibited. A baseline Doppler evaluation was performed in the fasting state, and consecutive Doppler evaluations were performed postprandially with 30-min intervals for 120 minutes. Doppler sonographic measurements of the superior mesenteric artery, including peak systolic and end-diastolic velocities, resistive index, and diameter, were calculated. Statistical analysis was performed by analysis of variance. RESULTS: All groups showed significant changes with time for all parameters (P < .001 for all). The changes in time were significantly different at 90 and 120 minutes for peak systolic velocity, at 90 minutes for end-diastolic velocity, and at 120 minutes for diameter between groups. Group B had the greatest differences. Compared with group A, changes in peak systolic velocity at 90 to 120 minutes were significantly lower in group B (P = .007 and .006, respectively), and compared with groups A and C, changes in end-diastolic velocity at 90 minutes (P = .006 and .004, respectively) and diameter at 120 minutes (P = .007 and .011, respectively) were significantly lower in group B. CONCLUSIONS: Smoking immediately after meals was associated with a superior mesenteric artery blood flow increase that was lower than expected, which may explain the belief that smoking reduces body weight. Postprandial smoking may have undesired results in patients with chronic intestinal ischemia.     

新生儿窒息合并胎粪吸入综合征肾血流动力学的超声研究

[目的]探讨轻度窒息合并胎粪吸入综合征(MAS)新生儿肾脏血流动力学变化特点.[方法]选择2015年7月至2016年7月本院新生儿科收治的轻度窒息足月新生儿30例,根据其是否合并MAS将其分为非MAS组及MAS组,每组各15例.同时选择同期出生的健康足月新生儿16例作为对照组.所有新生儿均在出生后24 h内、d3、d7采集肾脏血流动力学数据,于其安静入睡状态下运用彩色多普勒探测双侧主肾动脉血流动力学参数,包括收缩期最大峰值流速(PSV)、舒张期最小流速(EDV)、阻力指数(RI).[结果]非MAS组、MAS组患儿出生d1时PSV、EDV均低于对照组正常新生儿,RI均高于对照组,差异均具有统计学意义(均P＜0.05);MAS组患儿出生d1时EDV低于非MAS组,RI均高于非MAS组,差异均具有统计学意义(均P＜0.05).MAS组患儿出生d3时PSV、EDV均低于非MAS组、对照组,差异均具有统计学意义.非MAS组、MAS组患儿出生d7时PSV、EDV、RI与对照组比较,差异无统计学意义(均P＞0.05).非MAS组出生后d1时PSV、EDV最低,RI最高,出生后d3、d7时PSV、EDV逐渐增高,RI逐渐减低,出生后d1时PSV、EDV、RI与d7比较,差异具有统计学意义(均P＜0.05);MAS组出生后d1时PSV、EDV较低,RI最高,出生后d3时PSV进一步减低,EDV稍升高,RI最低,出生后d7时PSV、EDV、RI均升高,以PSV升高最明显,出生后d1时PSV、EDV、RI与d7比较,差异有统计学意义(P＜0.05);对照组三次测值PSV、EDV呈逐步升高趋势,RI呈减低趋势,但组内比较,差异无统计学意义(P＞0.05).[结论]轻度窒息新生儿其肾供血减少,以EDV为甚,轻度窒息合并MAS时,肾血流减少更明显,且延续时间长,恢复慢,提示彩色多普勒超声可及时监测新生儿肾脏供血改变并为临床治疗提供参考依据.     

彩色多普勒超声监测妊娠期高血压疾病子宫螺旋动脉分析

目的探讨彩色多普勒超声监测对妊娠期高血压疾病的意义。方法观察我院收治的妊娠期高血压疾病孕妇45例(疾病组)及正常孕晚期孕妇475例(正常组)彩色多普勒超声子宫螺旋动脉血流频谱,并对搏动指数(PI)、阻力指数(RI)及收缩期最大血流速度与舒张末期血流速度比(S/D)进行比较。结果正常组彩色多普勒超声子宫螺旋动脉血流频谱,收缩期上升缓慢,舒张期下降缓慢且持续存在,收缩期及舒张期均为低流速,呈"低阻型",PI、RI及S/D在正常范围;疾病组彩色多普勒超声子宫螺旋动脉血流频谱,收缩期上升曲线陡直,下降曲线稍缓慢,PI、RI及S/D较正常组高,两组比较差异均有统计学意义(P0.05)。结论应用彩色多普勒超声监测子宫螺旋动脉可为妊娠期高血压疾病患者临床诊断及治疗提供可靠依据。     

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.     

彩色多普勒血流显像对前列腺癌的诊断意义

目的：观察前列腺被膜上动脉和前列腺被膜下－动脉以及结节内的异常血流信号,旨在探索经直肠彩色普勒血流显像对前列腺癌的诊断意义。方法：以经直肠彩色多普勒血流显像对１４例前列腺癌患者和３０名正常人前列腺被膜上,下动脉进行检测。所用指标为：最大流速（Ｖｍａｘ）;最低流速（Ｖｍｉｎ）,平均流速（Ｖｍｅｎａ）;博动指数（ＰＩ）,阻力指数（ＲＩ）和最大流速与最低流速之比（Ａ／Ｂ值）。结果：前列腺癌组患者的最大流     

彩色多普勒超声对早期糖尿病肾病的诊断价值

目的通过观察各级肾内动脉血流动力学指标变化情况,探讨彩色多普勒血流显像技术对早期糖尿病肾病的临床诊断价值。方法选择33例糖尿病患者,排除合并心衰、泌尿系感染、结石、肾血管疾病及其他原因致肾脏原发、继发病变,所有患者尿微量蛋白阴性,24h肌酐清除率均正常。同时选择32例健康者作为对照组,对受试者的肾主动脉、段动脉、叶间动脉进行检查,并对其血流的收缩期最大血流速度(Vsmax)、舒张期最低血流速度(Vdmin)和阻力指数(RI)进行比较分析。结果糖尿病组各级肾内动脉的血流的Vsmax依次为(57.03±20.18)、(38.55±13.61)cm/s,Vd min为(26.94±14.20)、(19.29±7.52)、(14.35±4.42)、(10.47±4.27)cm/s,均较对照组低,差异均有统计学意义(t分别=1.94、1.77、1.90、2.95、2.32、2.13,P均<0.05)。而RI均高于对照组,差异均有统计学意义(t分别=4.03、4.33、6.19,P均<0.05)。结论肾动脉血流动力学指数和肾彩色多普勒血流显像对诊断早期糖尿病肾病有重要的临床价值。     

Quantitative flow measurements for classification of ovarian tumors by transvaginal color Doppler sonography in postmenopausal patients.

Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end-diastolic and time-averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26-1.0) for benign and 0.40 (0.22-0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2-61.5 cm/s) for benign and 47.05 cm/s (14.6-105.0 cm/s) for malignant tumors).Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77-85%, specificity of 77-83% and accuracy of 80-84%. Differentiation was superior by calculation of the maximum end-diastolic velocities and by the summation of the systolic, end-diastolic and time-averaged maximum flow velocities: sensitivity 90-9.5% specificity 83-86% and accuracy 87-91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role.     

Doppler analysis of the umbilical artery. The importance of choosing the placental end of the cord

Thirty normal pregnancies were studied with continuous or pulsed Doppler ultrasound (50 measurements). The ratio of systolic (S) to end-diastolic (D) measurement, or S/D ratio, was obtained at both ends of the cord: the placental insertion and the fetal abdominal insertion. A statistically significant difference was demonstrated between the two sets of measurements. Normal values were obtained at the placental insertion, whereas, simultaneously, the fetal abdominal insertion generated highly abnormal values. When performing Doppler waveform analysis of the umbilical artery, if abnormal values are obtained, one should be cautious to be certain that they originated from the placental insertion.     

Resistance and pulsatility index increase in capsular branches of testicular artery: Indicator of impaired testicular microcirculation in varicocele?

PURPOSE: To evaluate the effect of clinical varicocele on testicular microcirculation using spectral Doppler analysis. METHODS: Forty-nine young and healthy volunteers were enrolled in this prospective study. Varicocele grades were determined according to sonographic parameters. Patients with left-sided clinical varicocele were classified as the patient group (n = 15), while the remaining patients served as controls (n = 34). Spectral Doppler measurements of testicular arteries (peak systolic/end diastolic velocity, resistance index, pulsatility index) were measured from capsular and intratesticular branches. RESULTS: No statistically significant difference was found between the Doppler parameters obtained from the intratesticular branches of both testes and the capsular branches of the right testis. On the other hand, in left-sided clinical varicocele cases, the average resistance index (RI) and pulsatility index (PI) of capsular branches of the left testes (RI, 0.68 +/- 0.04; PI, 1.22 +/- 0.15) were significantly greater than in the control group (RI, 0.64 +/- 0.06; PI, 1.07 +/- 0.18) (p < 0.05 and p < 0.01, respectively). CONCLUSIONS: Increased RI and PI of capsular branches of testicular arteries on spectral Doppler examination may be an indicator of impaired testicular microcirculation in patients with clinical varicocele. Further studies addressing the correlations with sperm counts are needed to determine the cut-off values for these indices.     

Effects of Cytotoxic T Lymphocyte-Associated Antigen 4 Immunoglobulin Combined with Microbubble-Mediated Irradiation on Hemodynamics of the Renal Artery in Rats with Diabetic Nephropathy

Cytotoxic T lymphocyte-associated antigen 4 immunoglobulin (CTLA-4-Ig) can inhibit the effect of B7-1 and improve renal hemodynamics in rats with diabetic nephropathy (DN). Nevertheless, a strategy that could increase the permeation of CTLA-4-Ig through endothelial cells and basement membrane remains to be discovered. We investigated the effect of CTLA-4-Ig combined with microbubble-mediated irradiation on the hemodynamics of renal arteries in DN rats. Rats were treated with CTLA-4-Ig and/or microbubble exposure. After 8 wk of intervention, color Doppler ultrasonography was used to detect peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), systolic acceleration (SAC), pulsatility index (PI) and resistance index (RI) of the renal artery trunk. The CTLA-4-Ig + microbubble exposure group exhibited significantly higher PSV, EDV and MV than the CTLA-4-Ig group, which had significantly higher values than the non-intervention group. The CTLA-4-Ig + microbubble exposure group exhibited significantly lower SAC, PI and RI than the CTLA-4-Ig group, which had significantly lower values than the non-intervention group. Our results indicate that both CTLA-4-Ig and CTLA-4-Ig + microbubble exposure can reduce the blood flow resistance and improve the blood flow velocity of renal arteries in rats. Moreover, the effect of CTLA-4-Ig + microbubble exposure is better than that of CTLA-4-Ig alone. Our study provides a new, effective and non-invasive strategy for the treatment of DN.     

超声评价辛伐他汀对兔脑动脉粥样硬化的影响

目的探讨超声评价早期脑动脉粥样硬化的价值及辛伐他汀的治疗作用。方法24只兔随机平均分成3组:正常对照组(A组)、高脂模型组(B组)、辛伐他汀治疗组(C组)。12周末超声分别测量颈总动脉内膜-中层厚度(IMT)、颈总动脉、椎动脉、基底动脉收缩期峰值流速(Vs)、搏动指数(PI)、阻力指数(RI)。截取动脉行病理学检查。结果B组、C组颈总动脉IMT增厚,PI、RI增高,与A组比较差异显著,C组测值较B组减低(P<0.05)。椎动脉和基底动脉PI、RI测值组间差异显著(P<0.05),B组PI、RI较A组显著增高,C组较B组明显减低(P<0.05)。各组Vs差异均无显著性意义(P>0.05)。结论超声检测颈总动脉结合椎、基底动脉,为诊断早期脑动脉粥样硬化提供了可靠的方法,辛伐他汀具有抗动脉粥样硬化作用。     

Feasibility of UltraFast Doppler in Post-operative Evaluation of Hepatic Artery in Recipients following Liver Transplantation

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.     

经阴道超声多普勒检测134例卵巢动脉的血流变化

本文利用TVS-CDFI技术对134例受试者的卵巢动脉血流进行了研究,其中包括36例正常妇女。134例卵巢动脉血流频谱被显示。对A、B、A/B、PI,RI进行了测量,结果表明:卵巢恶性肿瘤的B、A/B、PI、RI与正常卵巢及卵巢良性肿块测值比较,有显著性差异(P<0.05);卵巢良性畸胎瘤的B、A/B、PI、RI与正常卵巢及卵巢良性肿块测值比较,有显著性差异(P<0.05);卵巢良性畸胎瘤的B、PI,RI与卵巢其它良性肿块及正常卵巢测值相比也有显著性差异(P<0.05)。表明TVS-CDFI检测卵巢动脉血流对鉴别卵巢的良、恶病变有意义。     

Power Doppler Ultrasonography of the Feeding Arteries of the Prostate Gland

OBJECTIVE: The purpose of this study was to assess the role of spectral Doppler ultrasonographic parameters of the feeding arteries of the prostate for the detection of prostate cancer. METHODS: A total of 55 patients referred for prostate biopsy with a mean age of 66.4 years (range, 46-82 years) were included. In each patient, Doppler indices from bilateral capsular and urethral arteries were obtained. The indices were compared with regard to malignant (group A) and benign (group B) subgroups of histopathologic outcomes of transrectal ultrasonographically guided prostate biopsy for each side (n = 19 and n = 91 for groups A and B, respectively) and to assess whether the indices were significantly altered on the side with cancer compared with the contralateral side. RESULTS: The mean pulsatility index value for the capsular artery of group A (1.49 +/- 0.57) was significantly lower than that of group B (1.71 +/- 0.52; P = .048). The mean resistive index and systolic/diastolic ratio for the capsular artery of group A (0.78 +/- 0.10 and 5.40 +/- 2.74, respectively) were lower than those of group B (0.82 +/- 0.08 and 7.40 +/- 4.91) despite being statistically insignificant (P = .075 and .119, respectively). CONCLUSIONS: Spectral waveform measurements by power Doppler transrectal ultrasonography may be useful in differentiating prostate cancer from benign hypertrophy. Further research is needed to elucidate the potential of spectral Doppler indices of the capsular and urethral arteries.     

Antenatal umbilical coiling index and Doppler flow characteristics.

OBJECTIVE: To evaluate whether a relationship exists between the antenatal umbilical coiling index (UCI) and umbilical cord Doppler flow characteristics. METHODS: During the fetal anatomical survey in 200 consecutive pregnant patients at 18-23 weeks' gestation, we recorded umbilical coiling patterns and blood flow characteristics. The antenatal UCI, calculated as a reciprocal value of the distance between a pair of umbilical cord coils, was compared with Doppler parameters including umbilical vein blood flow volume (in mL/min/kg), and mean resistance index (RI) and peak systolic velocity (PSV in cm/s) averaged from both umbilical arteries. RESULTS: A total of 154 patients met the inclusion criteria of singleton pregnancy and having adequate sonographic umbilical cord images, Doppler flow indices, and all demographic, antenatal and labor data. The mean antenatal UCI was 0.40, with 10th and 90th centiles of 0.20 and 0.60, respectively. The mean +/- SD umbilical artery RI and PSV and umbilical vein blood flow volume were 0.74 +/- 0.07, 25.1 +/- 6.4 cm/s, and 264 +/- 106 mL/min/kg, respectively. All Doppler variables correlated significantly with antenatal UCI, with lower RI and higher PSV and umbilical vein blood flow volume values being associated with higher antenatal UCI (P = 0.016, P < 0.001, and P = 0.032, respectively). However, when stratified by antenatal UCI into hyper- (above 90th centile), normo- (10th-90th centile), and hypocoiled (below 10th centile) umbilical cord groups, a significant difference was observed for PSV only (P = 0.016). CONCLUSION: It appears that umbilical cord coiling modulates noticeably blood flow through the umbilical cord. We speculate that more prominent umbilical coiling (higher antenatal UCI values) has a protective effect on blood flow in terms of decreased arterial resistance and higher blood flow velocities, as well as increased venous blood flow. However, due to lack of significant differences between Doppler characteristics when stratified by antenatal UCI into hypo-, normo-, and hypercoiled groups, the clinical implications of this observation are uncertain.     

Quantitative characterization of arcuate artery hemodynamic change in normal pregnancy with Doppler ultrasonography

Using color and pulsed Doppler ultrasonography, arcuate arterial velocimetry was carried out in 91 normal women, at 16–40 weeks, menstrual age. The arcuate arterial hemodynamics was assessed by the calculation of the resistance index (RI). A curvilinear relationship was found between the RI value of the arcuate artery obtained from the placental site in the uterus and menstrual age (R² = 0.328). The relationships between the RI value of the arcuate artery obtained from the nonplacental site (R² = 0.268) or the averaged RI value between the placental and nonplacental sites (R² = 0.321) and menstrual age were both linear. Normal ranges of RI values of arcuate arteries during pregnancy for the placental site, nonplacental site, and their average values were generated. These results provide a foundation for evaluating uteroplacental velocimetry in normal pregnancy using Doppler ultrasonography. © 1993 John Wiley & Sons, Inc.     

彩色多普勒超声监测斜视手术对眼血流动力学影

目的 :探讨斜视手术对眼血流动力学影响 ,评价多普勒超声监测眼动脉血供的临床价值。方法 :筛选斜视患者 51例 51只眼行 1或 2条水平直肌后徙 -截腱术。术前、术后 1周、 1个月分别用彩色多普勒超声诊断仪测量眼动脉 (OA)、睫状后动脉 (PCA)、视网膜中央动脉 (CRA)的收缩期血流速度峰值 (Vs)、舒张末期血流速度 (Vd)及阻力指数 (RI) ,比较血流改变并与 3 0例正常人对照。结果 :1.斜视眼术前患眼 OA、 PCA、 CRA血流参数与正常组比较无显著性意义 (P>0 .0 5) ;2 .斜视眼术后 1周眼动脉 Vs明显升高、 PI、 RI升高 (P<0 .0 5) ;3 .斜视眼术后 1个月 OA、PCA、 CRA各血流参数与术前比较 ,无显著性意义 (P>0 .0 5)。结论 :手术可以引起短期眼组织缺血 ,但随着手术激惹的消失及广泛侧枝循环的建立 ,1条或 2条水平直肌截断手术不会引起眼前节缺血 ,多普勒超声是评价眼血流动力学变化的敏感方法     

Fetal adrenal artery velocimetry measurements in appropriate-for-gestational age and intrauterine growth-restricted fetuses.

OBJECTIVE: To investigate adrenal artery blood flow in the fetus. DESIGN AND METHOD: Sixty-two appropriate-for-gestational-age (AGA) and 20 intrauterine growth-restricted (IUGR) fetuses were recruited to this cross-sectional study between 22 and 42 weeks of pregnancy in a tertiary referral fetal medicine unit of a university hospital. ENDPOINTS: Doppler velocimetry of the fetal adrenal, umbilical (UA), renal and middle cerebral arteries (MCA). Pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), time-averaged maximum velocity (TAMXV) and cerebroplacental ratio (MCA RI/UA RI; CPR). Obstetric outcome. RESULTS: The adrenal artery was detected in 82% of the fetuses. All flow velocity waveforms obtained from the adrenal artery indicated low impedance blood flow. No significant changes in PI, RI, PSV and TAMXV occurred with advancing gestation. The blood flow parameters of the adrenal artery did not differ between AGA and IUGR fetuses. In five IUGR fetuses with signs of redistribution of cardiac output in favor of the brain, the adrenal artery velocimetry results were unremarkable. The adrenal artery PI, RI, PSV and TAMXV values were higher in female fetuses than in male fetuses (P < 0.05). A relationship was observed between the velocity measurements and the estimated fetal weight (P < 0.01). CONCLUSIONS: The fetal adrenal artery could be readily detected. We observed no redistribution of blood flow in favor of the fetal adrenals in IUGR fetuses which were not severely compromised.