乳腺良恶性病变血流分级与收缩期峰值和阻力指数的相关性研究

目的探讨乳腺病变的血流分级与收缩期峰值（PSV）和阻力指数（RI）的相关关系及其对良恶性病变鉴别诊断的价值。方法观察分析213例经病理证实的乳腺肿块的多普勒血流特征,分析血流分级与PSV和RI的相关性。结果乳腺病变血流分级与RI和PSV无明显相关性;血流分级、RI与乳腺病变的良恶性有相关性。结论乳腺病变血流分级越高、RI值越大,病变恶性程度的可能性越大。     

彩超对乳腺癌术后腋窝血管血流动力学改变的临床观察

目的：探讨乳腺癌术后患者腋窝血管的血流动力学状态是否存在改变及应用彩色多普勒超声检查的可行性。方法：搜集我院69例右乳腺癌改良根治术后复查患者,用彩色多普勒超声观察其腋动脉、静脉的内径（internal diameter,ID）、收缩期最大流速（peak systolic velocity,PSV）、舒张末期流速（end diastolic velocity,EDV）、平均流速（time averge velocity,TAV）、搏动指数（pulsatility index,PI）及阻力指数（resistivity index,Ⅲ）,与正常组作对照,进行统计学处理。结果：术后患肢腋静脉的PSV、EDV、TAV值较正常对照组减慢约24．0％,36．7％,34．9％;患肢腋动脉收缩期、舒张期、平均流速分别降低23．7％,47．9％,28．3％,差异均有统计学意义（P〈0．05）。术后血管工ID、PI、RI未见明显改变。术后有上肢水肿者较无症状者腋静脉PSV、EDV、TAMAX值明显下降（P〈0．05）,而腋动脉各参数无明显改变（P〉0．05）。结论：乳腺癌改良根治术对腋窝血管的处理一定程度影响患侧上肢的血供。彩色多普勒超声检查腋窝血管血流动力学是一种可靠的方法。     

彩色多普勒超声及超声造影在乳腺癌新辅助化疗疗效评估中的价值

目的探讨彩色多普勒超声及超声造影对乳腺癌新辅助化疗(neoadjuvant chemotherapy,NAC)疗效评估中的应用价值。方法选取2014年1月—2015年6月收治的行NAC乳腺癌患者60例,分别于NAC前和NAC后应用彩色多普勒超声记录病灶大小、血流分级、血流阻力指数等指标;对其中26例行超声造影检查患者记录造影相关参数,包括造影剂到达肿瘤的时间、达峰时间及峰值强度。根据NAC前、后各项指标变化情况评估NAC疗效。结果NAC后病灶最大径、形态、边界、周边晕带、内部回声变化、血流分级及血流阻力指数均较NAC前差异有统计学意义（P<0.05）。NAC后造影相关参数到达肿瘤的时间、达峰时间及峰值强度均较NAC前有明显变化,差异有统计学意义（P<0.05）。结论超声造影可以通过检测乳腺癌NAC前、后各项指标变化情况,准确评估NAC疗效。     

Evaluation of the thyroid blood flow with Doppler ultrasonography in healthy school-aged children

OBJECTIVE: To determine the relationship between thyroid blood flow and anthropometric measurements, pubertal stage, and thyroid and gonadotropic hormones. MATERIALS AND METHODS: We examined 123 healthy school-aged children prospectively (69 boys (56.1%) and 54 girls (43.9%), 7-17 years old). Their sex, age, body weight, height, body mass index (BMI), and pubertal stage were determined. Serum thyrotropin, free thyroxine, luteinizing hormone, and follicle stimulating hormone were measured in both genders, along with testosterone in boys and estradiol in girls. The peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) of the superior thyroid artery were determined. The correlations between the Doppler parameters and these factors were investigated. RESULTS: There were no differences in age, weight, height, BMI, thyroid volume, PSV, RI, or PI between boys and girls (P>0.05). The PSV and PI showed strong correlations with age, height, weight, puberty stage, thyroid volume, and BMI. The RI showed a strong inverse correlation with age, height, weight, puberty stage, and thyroid volume and a weak inverse correlation with the BMI. CONCLUSION: Determination of the thyroid arterial flow in normal healthy children is important during a Doppler ultrasound (US) examination. Doppler US parameters and their percentiles should be described in healthy children from different age groups, and these percentiles will aid in interpreting Doppler US in children.     

高频彩色多普勒超声诊断乳腺微小癌的应用价值

 目的 探讨高频彩色多普勒超声在诊断乳腺微小癌中的应用价值。方法 选取经术后病理证实为乳腺癌且超声检查乳腺结节≤1 cm的42例患者(微小癌组),分析其声像图特征;并选择同期40例乳腺结节≤1 cm的良性病变患者(术后病理证实)作为对照组,比较两组微钙化、血流显示、阻力指数(resistance index,RI)。结果 两组微钙化、血流显示、RI 比较,差异均有统计学意义(P<0.05)。超声诊断乳腺微小癌的敏感度、特异度、Youden指数、诊断符合率分别为78.57%、92.50%、71.07%、85.37%。结论 高频彩色多普勒超声检查对乳腺微小癌的诊断、治疗具有重要临床应用价值。     

The role of colour flow Doppler in the investigation of the salivary gland tumour

AIMS: Ultrasound is a highly effective imaging technique to determine salivary gland tumours and may help to identify many benign lesions. The aim of this study is to evaluate whether colour Doppler is able to further differentiate the malignant tumour. METHODS: Fifty-six patients with salivary gland lesions were prospectively assessed using ultrasound imaging with colour flow and power Doppler. The peak systolic velocity (PSV) was measured and the pulsatility index (PI) and resistive index (RI) calculations were performed on the pulsed wave traces. The real time ultrasound morphology and the Doppler information were correlated with the histology. RESULTS: In 18 of the 56 patients, no internal colour flow or power Doppler changes could be detected. The real time ultrasound morphology diagnosed benign disease with sensitivity of 89.7% with specificity of 57.1%. The positive predictive value was 93.6%. There were no significant differences in the colour Doppler appearances in terms of vessel type or intratumour distribution which could separate benign from malignant conditions. However, there was statistical discrimination for PI and RI values (P = 0.0006, P = 0.0002, respectively). No malignant lesions were seen when the PI was less than 1.8 and RI was less than 0.8. The PSV was elevated in several cases (> 50 cm per s) but there was no statistical correlation with malignancy. CONCLUSION: The risk of malignancy increases by a third when the colour Doppler demonstrates increased intratumour vascular resistance (RI > 0.8 and PI > 1.8), with positive predictive value of 97.3% (sensitivity 75.5%, specificity 85.7%).Bradley, M. J. (2000). Clinical Radiology55, 759-762.     

Utility of color duplex sonography in the assessment of efficacy of the stellate ganglion blockade

Purpose: 
To assess the hemodynamic changes in the upper extremity arteries after sympathetic ganglion blockade (SGB) by using spectral Doppler parameters and to determine the applicability of these parameters for the evaluation of SGB efficacy. Material and Methods: 
Spectral Doppler parameters (peak systolic velocity (PSV), end diastolic velocity (EDV), mean velocity (mean V), flow volume, resistive and pulsatility indices (RI, PI), inner arterial diameters (intima to intima) (D) with simultaneous recordings of heart rate (HR), systolic and diastolic blood pressures and upper extremity surface temperature changes) were recorded before and 5 min after during the first, fifth and tenth SGB procedures. Results: 
SGB induced an increase in skin temperature in the ipsilateral hand and persistent dilatation of the radial diameter accompanied by reduction of RI and PI in the radial and third digital arteries in all patients. Conclusion: 
Hemodynamic changes assessed by spectral Doppler parameters could be used as sensitive and objective measurements of peripheral sympathetic nervous activity and vascular tonus, and may confirm a successfully performed SGB.     

彩色多普勒对视网膜脱离血液动力学研究

目的 :利用彩色多普勒技术评价视网膜脱离 (RD)患者球后血流动力学变化。方法 :视网膜脱离患者 3 5例 ,55只眼。对照组 2 6例 ,51只眼。彩色多普勒超声指导下 ,采用脉冲多普勒超声检测眼动脉 (OA)、视网膜中央动脉 (CRA)、睫状后动脉(PCA)收缩期 (PSV)、舒张期 (ESV)、平均血流速度 (AV)及阻力指数 (RI)、搏动指数 (PI)。结果 :RD与对照组的OA血流速度无明显差异 (P >0 .0 5) ;CRA、PCA的PSV、EDV、AV血流速度均减低 (P <0 .0 5) ;PI、RI值无显著性差异 (P >0 .0 5)。结论 :视网膜脱离的血流动力学的变化直接影响到视网膜的微循环状态。彩色多普勒超声可正确评估球后血流灌注情况与病变的关系 ,较传统的荧光血管造影法更为直接和敏感 ,为视网膜脱离的基础研究及药物辅助治疗提供了重要的依据     

经阴道彩色多普勒超声评价药物治疗输卵管妊娠的价值

目的:探讨经阴道彩色多普勒超声(TVCDFI)评价药物保守治疗输卵管妊娠的价值。方法:应用TVCDFI观察中西医结合保守治疗输卵管妊娠30例,患者治疗前及治疗后1周、2周、1月行阴道超声检查,并记录输卵管妊娠包块的二维声像图特征及多普勒血流动力学参数。结果:输卵管妊娠包块治疗前血流信号丰富,治疗后血流信号逐渐减少,差异具有显著性意义(P<0.005)。治疗1月后附件区包块收缩期峰值流速及舒张末期流速较治疗前明显减慢,P<0.001。治疗2周及1月后附件区包块阻力指数较治疗前明显升高,P<0.001。结论:输卵管妊娠包块大小、血流信号的丰富程度、血流流速的降低及阻力指数的增高以及盆腔积液量的多少是疗效评价客观的、有价值的指标。TVCDFI评价输卵管妊娠疗效有临床推广价值。     

高频超声对乳腺小肿块鉴别诊断的价值

目的:评价高频超声二维征象及彩色多普勒血流指标在乳腺小肿块鉴别诊断中的价值。方法:使用高频超声诊断仪观察196个长径小于2 cm的乳腺肿块的二维超声特征(包括病灶形态,病灶内部,病灶后方有无衰减及有无微小钙化灶),然后使用彩色多普勒对病变进行多普勒血流参数测定(包括血流丰富度、PSV、RI、PI)。比较二维超声征象及彩色多普勒血流参数在乳腺良、恶性肿块中的差异并对其诊断敏感性、特异性加以分析。结果:病灶形态、病灶内部、病灶后方及有无微小钙化灶良、恶性病变间均有显著性差异。恶性肿块PSV、RI、PI值均明显高于良性肿块。结论:彩色多普勒超声血流参数测定对乳腺良、恶肿块的鉴别诊断具有重要的参考价值,与肿块的二维声像图征象相结合可提高乳腺肿块的超声诊断准确率。     

Usefulness of Doppler waveform analysis in differential diagnosis of cervical lymphadenopathy

We compared Doppler spectral parameters in acute inflammatory, reactive, lymphomatous, and metastatic lymph nodes, and evaluated pulsed Doppler sonography as a method for distinguishing between different causes of cervical lymphadenopathy. Spectral Doppler analysis with measurements of resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) was performed in 197 patients with cervical lymphadenopathy. Results of Doppler analysis were compared with findings of cytology and histology or with clinical presentation and follow-up. Student's t-test was used to assess statistical significance of differences in Doppler parameters between groups of patients. Significant differences for RI and PI were shown between all groups of patients except between lymphomatous and reactive nodes. Specificity of 100% for metastatic nodal involvement was shown for cutoff values RI>0.80 and PI>1.80. A positive predictive value (PPV) of 100% for acute lymphadenitis was shown for cutoff values RI<0.50 and PI<0.60. An EDV>9 cm/s has 100% negative predictive value for nodal metastasis, and EDV<1 cm/s has 100% specificity and PPV for metastasis. Although there exist differences in RI, PI, PSV, and EDV between different nodal diseases, none of these parameters offer both good sensitivity and good specificity, and only extreme cutoff values may occasionally be helpful in differential diagnosis. Doppler spectral analysis is a valuable noninvasive adjunct which can help in differentiation between metastatic, lymphomatous, acute inflammatory, and reactive lymphadenopathy, but cannot obviate biopsy in the majority of cases. Electronic Publication     

输卵管妊娠血液动力学改变的彩色多普勒超声研究

目的对比分析输卵管妊娠（tubal pregnancy，TP）时双侧输卵管动脉血流，探讨彩色多普勒血流显像（color Doppler flow imaging，CDFI）诊断输卵管妊娠的价值。方法临床拟诊宫外孕患者40例，于术前行经阴道超声（transvaginal scanning，TVS）检查，CDFI显示双侧子宫动脉输卵管支血流，用脉冲多普勒检测收缩期最大流速（peak systolic velocity，PSV）、舒张末期流速（end diastolic velocity，EDV）、平均流速（time averge mature，TAMAX）、搏动指数（pulsatility index，PI）及阻力指数（resistivity index，RI），并进行统计学处理。结果40例均确诊为TP，其中33例黄体位于患侧，输卵管动脉血流信号较健侧丰富，色泽明亮鲜艳，血流频谱呈单向高舒张期、低阻特征，EDV、TAMAX明显高于健侧，PI、RI则明显低于健侧（P〈0．05），PSV双侧差异无统计学意义（P〉0．05）；5例黄体位于健侧者，所有参数差异无统计学意义（P〉0．05）。2例TP破裂出血者，患侧EDV、TAMAX均低于健侧，且PI、RI高于健侧。结论经阴道CDFI监测输卵管动脉血流有助于TP的早期定性和定位诊断。     

能量多普勒检测乳腺癌血流分布及其与腋窝淋巴结转移的关系

目的:研究乳腺癌的血流分布特点及其与腋窝淋巴结转移的关系。方法:通过能量多普勒(PDI)检测251例乳腺癌肿块内血流信号,结合波谱分析其与腋窝淋巴结转移的关系。结果:有淋巴结转移组乳腺癌肿瘤血供明显丰富,且最大血流峰值(PSV)和阻力指数(RI)较高(P<0.05)。结论:乳腺癌肿瘤血流分布情况与腋窝淋巴结的转移有很大的相关性。     

彩色多普勒血流显像和脉冲多普勒技术对乳腺肿块的诊断作用

目的 探讨彩色多普勒血流显像和脉冲多普勒超声在乳腺肿块诊断中的应用价值。方法 对90例乳腺肿块行彩色多普勒血流显像和脉冲多普勒血流研究，测量其血流参数。结果 乳腺恶性肿块内收缩期峰值血流速度（Vp)、阻力指数（RI）、搏动指数（PI）均高于良性肿块，两组间有显性差异（P＜0.01)。结论 在乳腺肿块诊断中，彩色多普勒血流显像和脉冲多普勒技术是一种简便、有效的辅助检查方法。     

Significance of the determination of Doppler sonography haemodynamic indices for the assessment of distal perfusion in patients with critical ischemia of lower limbs

BACKGROUND/AIM: The perfusion of tissue, especially the muscles of the lower limbs (LL), implies the blood flow that carries enough nutrition, energy materials and oxygen. The aim of this study was to determine whether the decreased Doppler sonography parameters, resistence index (RI), and pulsatility index (PI) were significant as indicatiors of irreversible ischemia of LL. METHODS: In 40 patients (mean age 66 +/- 14.9 years, 21% women and 79% men) with the signs of critical ischemia of LL, Lariche-Fontaine class III and IV, we performed contrast angiography of the LL arteries, and perfusion scintigraphy of LL using, thallium-201, while we performed Doppler sonography to determine resistance index (RI), as well as pulsatility index (PI). After that, all the patients were treated with vasodilatation using Bergmann's solution within a 10-day period. Following that, all the patients underwent the determination of haemodynamic indices RI and PI applying the methods of Doppler sonography. The obtained values of RI and PI indices revealed no clinical recovery which suggested the irreversibility of critical ischemia (unsuccessful therapy in 100% of the patients), and clinical recovery which suggested the reversibility of the disease (unsuccessful therapy in 80% of the patients). RESULTS: The obtained values of PI = 0-0.3 and RI = 0-0.25 for the examined LL arteries were the indicators of irreversible ischemia. A significant correlation between the values of RI in the distal parts of a. tibialis anterior and posterior was proved, as well as between the decreased perfusion of LL determined by tallium-201 (p < 0.05, r = 0.43), and a tibialis anterior (p = 0.05, r= 0.38). There was, however, no statistically significant correlation between the angiographic values and perfusion scintigraphy of LL. CONCLUSION: The obtained values of haemodynamic RI and PI indices should be a novel approach for introducing a new criteria for the assessment of reversible and irreversible critical ischemia of LL using the method od Doppler.     

高频彩超诊断视网膜中央动脉硬化的临床应用研究

目的探讨高频彩超诊断视网膜中央动脉硬化的临床应用价值。方法使用高频彩超检查40例眼底动脉硬化患者视网膜中央动脉,分析频谱形态,测量频谱收缩期、舒张期血流速度、阻力指数以及搏动指数。同时与正常组对照。结果眼底视网膜中央动脉硬化患病组彩色血流信号减少;舒张末期血流速度减慢;收缩期波峰园钝;舒张期血流低平、中断;血管阻力指数和搏动指数明显增大。结论视网膜中央动脉硬化有其彩色多谱勒血流和频谱异常表现特点。高频彩色多谱勒超声诊断该病有较充分的理论依据,有一定的临床诊断价值。     

彩色多普勒血流成像在检测子宫动脉栓塞术前后卵巢血流变化中的应用

目的 应用彩色多普勒血流成像技术(CDFI)从血液动力学水平了解子宫动脉栓塞术(UAE)对卵巢血供的影响.资料与方法 32例妇科良性疾病患者子宫动脉栓塞术前及术后1周、术后1个月和术后3个月分别用彩色多普勒血流成像技术测量子宫及卵巢动脉的血流变化参数,包括收缩期血流速度峰值(PSV)、舒张期末血流速度(EDV)及阻力指数(RI).结果 32例患者手术成功率为100％,术后所有患者临床症状均得到改善;栓塞前后卵巢动脉PSV、EDV及RI比较,差异无统计学意义(P＞0.05);栓塞前后子宫动脉PSV、EDV及RI比较,差异有统计学意义(P＜0.01).结论 子宫动脉栓塞术治疗妇科良性疾病是一种安全、有效的治疗方法,彩色多普勒血流成像技术可作为妇科良性疾病手术前后的检测方法,用来评价子宫动脉栓塞术的临床疗效.     

运动过程中人肾脏血流动力学超声特点

目的：探究在运动过程中人肾脏血流动力学的改变。方法选取我军某部216名战士进行5公里越野训练,作为实验组;同时选取60名平静状态下的战士作为对照组。应用彩色多普勒超声仪检查2组受检者的肾脏血流灌注情况及肾脏各级动脉血流动力学参数,包括收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV ）、血管阻力指数（RI）、血管搏动指数（PI）。结果实验组肾主动脉、段动脉、叶间动脉的PSV、RI、PI均较对照组减低,具有统计学意义。结论超声检查可以反映运动条件下人三级肾动脉的血流动力学改变,可为研究人体运动所引起的血流动力学的变化及其与肾功能方面的关系。     

The use of unenhanced Doppler sonography in the evaluation of solid breast lesions

OBJECTIVE: The objectives of our study were to investigate differences in Doppler sonography features between benign and malignant breast lesions and between malignant lesions with different prognostic factors and to propose diagnostic criteria for Doppler sonography of breast lesions. SUBJECTS AND METHODS: We performed power and duplex Doppler sonography examinations in 826 breast lesions scheduled for sonographically guided core needle biopsy. Lesion vascularity, pulsatility index (PI), and resistive index (RI) of the vessels detected were analyzed and correlated with histologic results. RESULTS: Color flow was more frequently seen in malignant (237/348 lesions, 68%) than in benign (171/478, 36%) lesions (p < 0.001). However, sensitivity, specificity, and positive and negative predictive values for this sign were low (68%, 64%, 58%, and 73%, respectively). The RI and PI values were significantly higher (p < 0.001) in cancers. Although an overlap in these values between benign and malignant lesions was observed, all but one nodule with an RI of greater than 0.99 (those with null or inverted diastolic flow) or a PI of greater than 4 were malignant. No significant relationship was found between PI, RI, or flow visualization on power Doppler sonography and tumor grade or lymph node involvement in cancers. CONCLUSION: Flow visualization on power Doppler sonography indicates a higher possibility of malignancy but is not useful as the main sign for malignancy. However, any lesion with a vessel that has an RI value greater than 0.99 or a PI value greater than 4 within it must be considered as probably malignant regardless of any other sonography sign present. Doppler findings are not useful to predict tumor grade or lymph node involvement.     

糖尿病眼底动脉血流动力学的彩色多普勒超声研究

目的:探讨糖尿病眼底血流动力学的变化。方法:彩色多普勒超声检测糖尿病患者67例和正常对照者40例的视网膜中央动脉(central retinal artery,CRA)、睫状后动脉(posterior ciliary artery,PCA)的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI),分析糖尿病视网膜病变(diabetic retinopathy DR)和糖尿病不伴视网膜病变(non-diabet-ic retinopathy,NDR)时其血流动力学的改变以及正常人不同年龄组血流参数的变化规律。结果:正常人不同年龄组间的PSV差异有显著性意义(P<0.05);不同年龄组间EDV、RI差异无显著性意义(P>0.05)。与对照组相比较,糖尿病患者PCA、CRA的血流速度减低,阻力指数增高,差异有显著性意义;且在无视网膜病变时不仅CRA而且PCA也存在血流动力学的异常。结论:彩色多普勒超声对糖尿病眼底动脉血流动力学变化的显示具有较高临床价值。