经颅多普勒超声对经皮颈动脉血管成形术和血管内支架术的脑血流及栓子的监测

目的⑶应用经颅多普勒超声⒉ Ｔ Ｃ Ｄ⒕动态监测脑血流动力学的变化及微栓子信号的产生⒚方法⑶经股动脉插管将缚有球囊及支架的导管输送至病侧颈动脉⒚采用 Ｔ Ｃ Ｄ 对 ３ 例成功实施 Ｐ Ｔ Ｃ Ａ 加 Ｓ Ｔ Ｅ Ｎ Ｔ 的患者⒙检测术前、术后双侧半球中、前、后及眼动脉血流⒙术中持续监测双侧中动脉流速及微栓子信号的变化⒚结果⑶术前 ３ 例患者双侧半球血流不对称⒙狭窄侧低流速、低搏动性血流⒙术后脑血流明显改善⒙双侧流速对称⒚术中均发现微栓子信号⒚结论⑶采用 Ｔ Ｃ Ｄ 可以有效地监测脑血流的变化及栓子信号的产生⒙评价 Ｐ Ｔ Ｃ Ａ 加 Ｓ Ｔ Ｅ Ｎ Ｔ 对颈动脉狭窄的治疗效果⒚     

彩色室壁动力技术多巴酚丁胺负荷试验在冠心病诊断中的应用

目的⑶探讨彩色室壁动力技术超声心动图对冠心病⒉ Ｃ Ａ Ｄ⒕患者室壁缺血部位检测的准确性和可靠性⒚方法⑶对拟诊或疑为冠心病者及正常人 ４０ 例全部进行 Ｃ Ｋ 超声心动图多巴酚丁胺负荷试验 ⒉ Ｃ Ｋ Ｄ Ｅｃｈ ｏ⒕⒙然后再与冠脉造影结果进行对照⒚结果⑶ Ｃ Ｋ Ｄ Ｅｃｈ ｏ 对于冠脉造影阳性、阴性组患者的诊断预测值分别为 ９１３０％ 、１００％ ⒙总预测值为 ９３９４％ ⒚其诊断 Ｃ Ａ Ｄ 的敏感性、特异性和准确性分别为 １００ ％ 、８３３３％ 和 ９３９４％ ⒚通过对心室壁缺血部位的观察⒙应用 Ｃ Ｋ 技术能够提高心内膜的显示率⒙避免人为因素⒙客观地做出室壁位移的时间值定量⒙明显优于二维超声法⒚结论⑶ Ｃ Ｋ Ｄ Ｅｃｈ ｏ 为 Ｃ Ａ Ｄ 诊断提供了一种安全、可靠的方法⒚     

三维超声对疣状胃炎、胃息肉的诊断与鉴别

目的⑶探讨三维超声成像在疣状胃炎、胃息肉的诊断与鉴别诊断中的应用价值⒚方法⑶采用 Ｔ Ｏ Ｍ Ｔ Ｅ Ｃ Ｅ Ｃ Ｈ Ｏ Ｓ Ｃ Ａ Ｎ 三维超声成像系统⒙连接 Ａｌｏｋａ Ｓ Ｓ Ｄ６５０ 型超声诊断仪⒙在空腹和应用胃快速显像液状态下观察胃部声像图⒙并进行三维重建⒚结果⑶三维超声诊断疣状胃炎 ２ ７ 例⒙其中胃窦部 １６ 例⒉５９３％ ⒕、胃体部 ６ 例⒉２２２％ ⒕、胃窦胃体部 ５ 例⒉１ ８５％ ⒕⒛胃息肉 １３ 例⒙其中胃窦部 ８ 例⒉６１５％ ⒕、胃体部 ５ 例⒉３８ ５％ ⒕⒚三维成像显示疣状胃炎呈圆柱状隆起⒙大多顶部扁平⒙底部较窄⒛胃息肉呈球状隆起⒙顶部圆钝、底部宽⒚结论⑶三维超声较二维超声能更有效地诊断和鉴别疣状胃炎与胃息肉⒚     

415例医用B超诊断仪故障分析

超声技术从四十年代进入医学领域以来发展非常迅速⒙尤其Ｂ型超声和超声多普勒诊断技术及近几年介入超声治疗更为突出⒚目前已大量进入各级卫生部门⒚为充分发挥仪器使用效率⒙缩短故障停机时间⒙笔者根据近十年来维修仪器的记录进行统计分析⒙小结成文⒙供同行参考⒚仪器型号日本阿洛卡⑶ＳＳＤ２１０⒙ＳＳＤ２５６⒙ＳＳＤ２６０⒙ＳＳＤ２８０⒙ＳＳＤ５００⒙ＳＳＤ６１０⒙ＳＳＤ６２０⒙ＳＳＤ６３０⒙ＳＳＤ７１０／７２０⒙ＳＳＤ８７０⒙日本岛津⑶ＳＤＬ３０／３２⒙ＳＤＬ３１０⒚日本东芝⑶ＳＡＬ２…     

超声心动图对全腔静脉与肺动脉连接手术前后心功能评价

目的⑶本文应用超声心动图对 ２ ７ 例实施全腔静脉与肺动脉连接手术患者进行左室收缩功能研究⒙比较 手术前后左室收缩功能参数、左室舒张末期容积⒉ Ｅ Ｄ Ｖ ⒕、左室收缩末期容积⒉ Ｅ Ｓ Ｖ ⒕、每搏输出量⒉ Ｓ Ｖ ⒕、射血分数⒉ Ｅ Ｆ⒕及短轴缩短率⒉ Ｆ Ｓ⒕⒚结果⑶手术前后左室收缩功能多数在正常范围内⒚术后 Ｅ Ｄ Ｖ 较术前增加⒙ Ｐ＜ ００１⒚术后 Ｅ Ｆ较术前略下降⒙ Ｐ＜ ００１⒚其它各项指标无差别⒚结论⑶超声心动图评价左心室收缩功能有意义⒙只要术前选择左室收缩功能良好者⒙术后左室功能一般不受影响⒚     

彩超诊断炎性乳癌1例

患者女性⒙４８岁⒙因一月前发现右侧乳腺外上象限有一包块⒙近来乳房突然肿大而入院⒚体格检查⑶右侧乳腺明显大于左侧⒙皮肤潮红⒙触之坚硬⒚彩超检查所见⑶右侧乳腺腺体弥漫性增厚⒙内部回声紊乱⒙导管未见扩张⒛彩色多普勒示⑶其内可见丰富的高速血流⒉图１⒕⒛脉冲多普勒示⑶血流阻力指数为０３８⒉图２⒕⒚彩超诊断⑶右侧乳腺炎性乳癌⒚手术所见⑶整个乳腺增大⒙图１　乳腺内丰富的血流作者单位⑶０５６２０１　河北省峰峰矿务局第二医院功能科图２　血流最大流速ＭＡＸ＝１５３ｍ／ｓ⒙阻力指数为０３８内呈泡状红灰色烂肉样组…     

超声诊断中孕胎盘梗死并胎儿面胎膜剥离1例

患者女⒙２５岁⒙孕６＋月⒙阴道流血半月余伴大量流血一次来诊⒚超声检查⑶左骶前位⒙胎心正常⒙双顶径６６ｃｍ⒙羊水平均作者单位⑶２４６００３　安徽省安庆市海军安庆医院特检科深度５５ｃｍ⒚胎盘位于子宫后壁⒙增厚５２ｃｍ⒙成熟度Ⅰ级⒚绒毛板下及胎盘实质内见多个大小不等的液性暗区⒙呈蜂窝状回声改变⒉图１⒕⒙ＣＤＦＩ示暗区内未见彩色血流显示⒚超声诊断⑶１单胎存活中孕⒛２胎盘实质内蜂窝状回声改变⒉胎盘梗死可能性图１　ＡＦ⑶羊水　　ＰＬ⑶胎盘大⒕⒛３考虑胎儿面胎膜剥离⒚引产胎儿娩出后检查胎盘⒙见胎儿…     

彩色多普勒超声在腹主动脉瘤腔内隔绝术前的应用

目的 探讨彩色多普勒血流显像（ＣＤＦＩ）在腹主动脉瘤（ＡＡＡ）腔内隔绝术术前的应用价值。方法应用ＣＤＦＩ对３２例ＡＡＡ患者术前进行检测,主要检测内容包括瘤体的大小,瘤体近远端颈的长度、内径及双侧髂总动脉的内径;对瘤体、瘤颈及双侧髂总动脉的形态进行观察;判断患者行ＡＡＡ腔内隔绝术的可行性。结果 术前超声诊断的特异性、敏感性均为１００％,２３例行手术治疗的患者中,术前超声对２０例患者术式的选择作出了正     

彩色多普勒超声诊断椎动静脉瘘1例

患者⒙女⒙４１岁⒚于主动脉瓣及二尖瓣人工瓣膜置换术后二个月偶感头痛⒙头晕⒙来院检查⒙体检发现右颈部杂音⒙行彩色多普勒超声检查⒙见右颈总动脉⒙颈内、外动脉及颈内静脉管壁清晰⒙彩色多普勒血流显像⒉ＣＤＦＩ⒕及脉冲多普勒频谱⒉ＰＷ⒕均未探及异常血流信号⒚右椎动脉起始部管壁平整⒙管腔内清晰⒙ＣＤＦＩ示血流充盈良好⒙ＰＷ示收缩期最大流速⒉Ｓｍａｘ⒕１０８ｃｍ／ｓ⒚于距起始部约３０ｃｍ处椎动脉管壁有一瘘口直径约０３ｃｍ⒉图１⒕⒚将取样容积置于瘘口处测得收缩期高速的连续性频谱Ｓｍａｘ２０８ｃｍ／ｓ⒉图２⒕…     

血流动力学对能量多普勒显像的影响研究⑶血液浓度的影响

目的⑶观察在实验模型中不同血液浓度对 Ｐ Ｄ Ｉ和 Ｃ Ｄ Ｆ Ｉ的影响⒚方法⑶在 ３ｍ ｍ 内径硅胶管中模拟不同血液浓度 ⒉１％ ～１００％ ⒕的血流⒚分别记录 Ｐ Ｄ Ｉ和 Ｃ Ｄ Ｆ Ｉ血流图⒙用计算机分析各血流的彩色像素面积 ⒉ Ｃ Ｐ Ａ⒕和彩 色亮度 ⒉ Ｃ Ｖ ⒕⒚结果⑶血液浓度与 Ｐ Ｄ Ｉ血流的 Ｃ Ｖ 值相关性较好 ⒉ｒ＝ ０ ７９２⒙ Ｐ ＜ ００５⒕⒙而与 Ｃ Ｐ Ａ 相关性较差⒉ｒ＝ ０６９２⒙ Ｐ＞ ００５⒕⒛血液浓度与 Ｃ Ｄ Ｆ Ｉ血流的 Ｃ Ｖ 无关 ⒉ｒ＝ ００７２⒙ Ｐ ＞ ００５⒕⒚结论⑶血液浓度与 Ｐ Ｄ Ｉ血流的彩色亮度有关⒙而对 Ｃ Ｄ Ｆ Ｉ的彩色亮度无影响⒚     

Full-Volume Assessment of Abdominal Aortic Aneurysm by Improved-Field-of-View 3-D Ultrasound Performs Comparably to Computed Tomographic Angiography

Three-dimensional ultrasound (US) of abdominal aortic aneurysms (AAAs) is limited by the field-of-view of the 3D-US transducer. To obtain an extended field-of-view (XFoV), two transducer navigation system-assisted US protocols have been developed: XFoV-2D and XFoV-3D. In this study, the XFoV US protocols were compared with the currently available 3D-US protocol with standard field-of-view (FoV-st) and the established gold standard, computed tomography angiography (CTA). A total of 65 patients with AAA were included, and AAA imaging was processed offline with prototype software. The novel XFoV-2D and XFoV-3D protocols allowed for assessment of full AAA volume in significantly more patients (45/65 [69%] and 43/65 [66%], respectively), compared with the current 3D-US standard, FoV-st (30/65 [46%] patients). The mean difference in AAA volume estimation between each XFoV US protocol and 3-D CTA differed significantly (XFoV-2D: 16.9 mL, XFoV-3D: 7.6 mL, p = 0.002), indicating that XFoV-3D agreed best with 3D-CTA. No significant difference was found in the variance of full AAA volume quantification between each XFoV US protocol and CTA (p = 0.49). It is concluded that the XFoV US protocols improved the generation of full AAA volumes compared with the currently available 3D-US technology, with AAA volume estimates comparable to CTA estimates.     

Role of contrast-enhanced 3D magnetic resonance portography in evaluating portal venous system compared with color Doppler ultrasonography

Aim The purpose of this study was to evaluate the capability of contrast-enhanced three-dimensional (3D) MR portography in detecting abnormal findings associated with the portal venous system compared with the results of color Doppler ultrasonography (CDUS). Materials and methods MR portography findings were retrospectively compared with the results of CDUS examinations in 161 patients, who were suspected of having portal venous system abnormalities. Portal venous vessels were divided into main 5 groups including the main portal vein, its left and right intrahepatic branches, splenic vein and superior mesenteric vein. Imaging findings were classified as normal, occluded, or partially thrombosed. Results of clinical and imaging follow-up examinations including CDUS, MR portography or angiography, if available, were used as a proof of final diagnosis. The potential sites of varicose veins and collateral vessels were also examined by both imaging methods. Results Vascular abnormalities were identified in 79 of 161 patients. There was a statistically significant agreement between the results of MR portography and CDUS in evaluating portal venous system (κ = 0.871, P < 0.05). The sensitivity of MR portography was slightly superior to CDUS in detecting partially thrombosis and occlusion in the main portal venous vessels. In addition, MR portograms were superior to CDUS in the management of patients with portal hypertension by identifying portosystemic collaterals more adequately, and clearly demonstrated portal venous vessels that cannot be visualized at CDUS. Conclusion Results of present study indicates that contrast-enhanced 3D MR portography is well suited and superior to CDUS in the management of patients with portal hypertension.     

肺实变的超声特征及其诊断价值

目的探讨肺实变的超声特征及其诊断价值。方法对125例实变肺的二维及彩色多普勒超声表现进行回顾性对比分析。结果含气或含液管状结构以及分支状血流信号是超声诊断肺实变的重要特征。彩色多普勒超声显示实变肺内血流信号有较高敏感性（92．7％），对含气或含液管状结构和肿块的检出率也高于灰阶超声，差异有显著性（P〈0．05）。超声在确定肺实变方面优于X-线检查（P〈0．005），与CT相比差异无显著性（P〉0．05）。结论彩色多普勒超声在肺实变的诊断中优于灰阶超声，是对X-线、CT等其他影像方法的一个很好补充。     

Intrarenal color duplex ultrasonography: a window to vascular complications of renal transplants.

OBJECTIVE: We analyze and discuss the importance of intrarenal color duplex ultrasonography (CDUS) in the diagnosis and differential diagnosis of vascular complications in renal transplants. METHODS: We retrospectively reviewed results of CDUS, especially intrarenal CDUS, in 102 consecutive inpatients with vascular complications of renal transplants from January 1, 2000, to December 31, 2006. Correlations between CDUS and magnetic resonance angiography, digital subtraction angiography, surgical findings, and clinical diagnoses were studied. RESULTS: Abnormal findings on intrarenal CDUS clearly represent vascular complications primarily located at the main renal vessels and intrarenal vessels. In our study, there were 5 cases of false-negative intrarenal arteriovenous fistulas, 1 case of false-positive transplant renal vein thrombosis, and 2 cases of false-negative transplant renal artery stenosis. The accuracy of detecting vascular complications of renal transplants with CDUS was 92% (94/102). CONCLUSIONS: Intrarenal CDUS is a noninvasive, accurate diagnostic tool that can be administrated portably and is easily repeatable, thereby making it not only a highly valuable imaging technique but also the method of choice in screening and diagnosing vascular complications of renal transplants.     

Volumetric blood flow measurement with color Doppler ultrasonography: the importance of visual clues

Volumetric flow rates were obtained in an in vivo canine pulsatile flow model using color Doppler ultrasonography (CDUS) and timed collection (TC) over a range which included laminar and turbulent flow. CDUS demonstrated increasing flow disturbance as flow rates increased, with effects on velocity profile, diameter measurements, and flow symmetry. Data comparing CDUS and TC showed marked differences in laminar flow (regression: slope = 1.02; r2 = 0.93; mean error, 11%) and nonlaminar flow (slope = 0.53; r2 = 0.78; mean error, 26%). Assigning the angle of insonation precisely was crucial to measurement accuracy. CDUS quantitates volumetric blood flow with a reasonable degree of accuracy under laminar flow conditions. Visual clues provided by CDUS can help avoid errors associated with deviations from laminar flow.     

Color Doppler sonography for ventral hernias in patients with acute abdomen: preliminary findings.

PURPOSE: We assessed the usefulness of color Doppler sonography (CDUS) in evaluating the vascular status of ventral hernias and distinguishing incarcerated from nonincarcerated ventral hernias. METHODS: In this prospective study, 10 patients who presented with acute abdomen and had ventral hernias underwent CDUS from August 1999 to May 2000. Patient age and sex and the clinical severity, mode of therapy, and outcome in these 10 patients were evaluated in relationship to the CDUS findings. RESULTS: Five patients had readily visible flow in the bowel within the hernial sac on CDUS. Two of these 5 had spontaneous reduction under conservative treatment, and 3 had asymptomatic ventral hernias with acute abdomen caused by spontaneous bacterial peritonitis. Barely visible flow was visualized in the bowel by CDUS in 4 other patients. Three of these underwent emergency surgery because of peritoneal signs; 2 of them were found to have ischemic changes in the bowel. The fourth patient underwent a successful manual reduction. The remaining patient had absent flow in the bowel on CDUS and underwent emergency surgery, which revealed gangrenous changes in the bowel. CONCLUSIONS: The intensity of the Doppler signals on CDUS appears to be a promising predictor of bowel viability in cases of ventral hernia. Thus, CDUS should impact the determination of the treatment plan, including whether to provide conservative treatment or surgery.     

门脉海绵样变的彩色多普勒超声诊断

目的：研究彩色多普勒在门脉海绵样变诊断中的应用,提高诊断的正确性。方法：对35例门静脉海绵燕变进行了彩色多普勒检查,先用两维图像显示肝门部结构、门脉主干及分支,以及周围侧枝血管回声,再用彩色多普勒显示血流方向、颜色。结果：根据形态学及超声表现可将门脉海绵样变分为三型：I型为肝外型;Ⅱ型为肝内型;Ⅲ型为肝内肝外型。门脉海绵样变的二维超声主要表现为：肝内外门静脉分支及主干狭窄或部分狭窄、闭塞,在其周围形成蜂窝状无回声区,门脉管壁回声增强,增厚,彩色多普勒超声显示血流呈红蓝相间,频谱多普勒显示门静脉血流呈毛刺状,为低速、平坦的血流流速曲线。结论：彩色多普勒血流显像对门脉海绵样变的诊断具有很高的准确性,是诊断门脉海绵样变的重要手段。     

彩色多普勒超声对肝移植术后并发症的诊断价值

目的评价彩色多普勒超声对肝移植术后并发症的诊断价值。方法回顾性分析和总结26例肝移植术后并发症的彩色多普勒超声检查资料,检测指标包括肝动脉及左右分支的峰值速度（HAPV）、阻力指数（RI）、加速度及加速时间,门静脉平均流速,肝实质及胆管回声。结果6例经手术或造影证实为血管并发症（肝动脉血栓形成1例,肝动脉狭窄2例,肝动脉痉挛1例,门静脉狭窄2例）,彩色多普勒超声表现有肝动脉狭窄处的高速高阻血流并伴有湍流,而狭窄远端峰值速度〈40cm／s,RI〈0．5,加速时间〉0．08s,加速度〈300cm／s^2,1例肝动脉血栓形成肝门部无动脉血流信号;6例急性排斥反应,3例胆管结石并扩张。结论彩色多普勒超声对肝移植术后血管并发症的诊断具有重要的指导意义。     

Pitfalls and sources of error of color duplex ultrasonography in detecting deep vein thrombosis of proximal lower extremities

Introduction　　TodetectDVTasaccuratelyandearlyaspossibleisveryimpor tantformanagingpulmonaryembolism .Immediateanticoagulationorinterventionalproceduressuchasvenacavafilterplacementorthrom bolysiswouldbeappliedifDVTdetected .Anticoagulationmaybewithheldifeitherpulmonaryembolism (PE)orDVTisnotfoundbe causeanticoagulationisassociatedwithanincreasedriskofmajorbleedingandotherpotentialseriousconsequences ,forinstance ,hep arin inducedthrombocytopenia[1] .Especiallyinsurgicalunit,there sultof…     

The role of high-resolution ultrasonography in management of calcific tendonitis of the rotator cuff

This article predicts the possibility of resorption of the calcific plaques in the shoulder using high-resolution ultrasonography (HRUS) and color Doppler ultrasound (CDUS), and evaluates the therapeutic effect of US-guided fine-needle multiple punctures of the calcific plaque. A total of 100 patients with calcific tendenosis were divided into 3 groups: In group 1, patients having chronic shoulder pain received conservative treatment; in group 2, patients having acute exacerbation of shoulder pain also received conservative treatment; and group 3 patients received US-guided fine-needle multiple punctures or aspiration. In CDUS, all images were classified as grade 0 (no color flow signals), grade 1 (weak spotty color flow signal), grade 2 (few rod-like color flow signals), grade 3 (many rod-like or linear color flow signals). In the follow-up study, marked improvement of patients' clinical condition with more than 50% size reduction of calcific plaque was defined as an effective treatment. There was no significant difference between group 1 and group 3 (p = 0.558) in CDUS, but there was a significant difference between group 1 and group 2 (p = 0.000), and group 2 and group 3 (p = 0.000) on the basis of classification of grade < 1 and grade > or = 1. There was also significant difference in the follow-up result of effective management between group 1 and group 3 (p = 0.000), and group 1 and group 2 (p = 0.000). In conclusion, HRUS with CDUS proved to be a good modality in evaluating the possibility of resorption of shoulder calcification and, if CDUS > or = grade 1 in calcific tendonitis, we highly recommend conservative treatment with regular follow-up. On the other hand, if CDUS < grade 1, fine-needle repeated puncture could be considered as an effective alternative treatment.