彩色多普勒血流显像检测下肢静脉瓣返流

目的：为探讨彩色多普勒血流显像（ＣＤＦＩ）检测静脉瓣返流的准确性。方法：４０条正常和３０条慢性静脉瓣功能不全（ＣＶＩ）下肢进行了ＣＤＦＩ检查，将下肢静脉分为股总静脉（ＣＦＶ）、股浅静脉（ＳＦＶ）、静脉（ＰＰＶ）、胫后静脉（ＰＴＶ）和隐股连接部（ＳＦＪ）五个节段。结果：正常下肢４８０个静脉节段的生理性返流时间９５％正常参考值上限为０．５ｓ。以静脉造影为对照，患肢异常节段较正常节段返流时间显著延长（Ｐ＜０．０１），以返流时间＞０．５ｓ做为静脉瓣病理返流的标准，立位乏氏法和挤压法的敏感性分别为８１．６％、８５．７％，特异性１００％、９０．９％和准确性８５．０％、８６．７％。结论：本文提示ＣＤＦＩ是无创性评价静脉瓣功能不全敏感且准确的方法。     

二维采色多为勒血流显像检测下肢慢性静脉瓣功能不全

为探讨二维彩色多普勒血流显像检测下肢慢性静脉瓣功能不全的价值，２６例３０条ＣＶＩ下肢静脉进行了２Ｄ－ＣＤＦＩ和Ｇｕｏ静脉穿刺造影检查，结果表明；ＣＶＩ下肢静脉和静脉瓣形态失常，乏氏法和挤压法后异常静脉节段显示逆向彩色血流和返流频谱。     

正常下肢静脉的二维彩色多普勒血流显像检查

目的：确定正常下肢静脉的超声特征。方法：对正常人３０例６０条下肢静脉进行了二维彩色多普勒血流显像（２Ｄ－ＣＤＦＩ）检查。结果：２Ｄ－ＣＤＦＩ可迅速清晰地显示下肢静脉的解剖图像,６５％可检出１～３个静脉瓣。正常静脉回流通畅,静脉瓣存在生理性返流。７２０个静脉节段的生理性返流时间为０．２３±０．１４ｓ,９５％正常上限值为０．５ｓ。结论：正常下肢静脉的超声检查,为下肢静脉疾病的诊断提供了理论依据     

彩色多普勒血流显像检测下肢慢性静脉瓣功能不全的临床应用

为探讨静脉瓣返流与病变严重程度的关系，２６例３０条慢性静脉瓣功能不全（ＣＶＩ）下肢静脉进行了彩色多普勒血流显像（ＣＤＦＩ）检查，其中溃疡患肢１２条，非溃疡１８条。采用患肢返流静脉节段数、总返流时间和深静脉总返流时间评估整体静脉瓣功能不全。结果表明：溃疡肢体显著伴有多个返流静脉节段，非溃疡患肢１～２个返流静脉节段１５条（１５／１８，８３．４％）；而溃疡患肢≥３个返流静脉节段１１条（１１／１２，９１．６％），两组比较有显著差异（Ｐ＜０．０１）。溃疡患肢总（８．８±３．２ｓｅｃ）和深静脉总返流时间（５．８±３．４ｓｅｃ）显著长于非溃疡患肢（分别为５．９±１．９ｓｅｃ，２．７±１．４ｓｅｃ），而大隐静脉返流时间二者无显著差异。本文提示ＣＤＦＩ检查静脉瓣返流可反应患肢病情     

二维彩色多普勒血流显像在下肢深静脉血栓中的应用

目的为探讨二维彩色多普勒血流显像（２ＤＣＤＦＩ）在下肢深静脉血栓（ＤＶＴ）中的应用价值。方法３０例３０条下肢ＤＶＴ进行了２ＤＣＤＦＩ检查,均经静脉造影证实。结果ＤＶＴ超声表现为腔内血栓回声;探头加压静脉腔不可压闭或部分压闭;腔内缺乏彩色血流信号或出现充盈缺损;脉冲Ｄｏｐｐｌｅｒ示无血流或血流频谱不随呼吸而变化。超声诊断符合率为９６７％（２９／３０）。结论２ＤＣＤＦＩ是评价下肢ＤＶＴ一种有价值的实用方法     

下肢深静脉血栓超声不同方法的对比研究

本文对４４例临床疑诊下肢深静脉血栓（ＤＶＴ）患者进行了二维彩色多普勒血流显像（２Ｄ－ＣＤＦＩ）和上行性静脉造影对比，旨在评估超声不同方法诊断ＤＶＴ的准确性。超声诊断ＤＶＴ的方法包括：血栓回声法（ＴＨ法）、探头加压法（ＣＯＭ法）、脉冲Ｄｏｐｐｌｅｒ法（ＰＤ法）和彩色Ｄｏｐｐｌｅｒ法（ＣＤ法）。３０条静脉造影确诊为ＤＶＴ，１４条阴性。单一指标以ＣＯＭ法最好，敏感性为９０．０％、特异性９２．８％和准确性９０．９％；不同指标联合以ＣＯＭ＋ＰＤ＋ＣＤ和ＴＨ＋ＣＯＭ＋ＰＤ＋ＣＤ法最佳，其敏感性均为９６．７％、特异性１００％和准确性９７．６％。超声是无创伤性评价下肢ＤＶＴ的敏感方法，全方位检查可更准确地诊断ＤＶＴ。     

彩色多普勒超声在原发性下肢深静脉瓣功能不全中的应用

目的　应用彩色多普勒超声诊断原发性下肢深静脉瓣功能不全。方法　应用彩色多普勒超声检测了２２个病人（３６条腿）和１５个正常人（３０条腿）的下肢股浅静脉、腘静脉瓣及内径、彩色返流信号、血流频谱及时间平均流速（ＴＡＶ）。结果　２２个深静脉瓣功能不全的病人均有股浅静脉〔（９．３６±２．０） ｍ ｍ ｖｓ（５．３５±１．０） ｍ ｍ ; Ｐ＜ ０．００１〕和腘静脉〔（９．９０±２．３） ｍ ｍ ｖｓ （５．０６±１．４） ｍ ｍ , Ｐ＜ ０．０１〕的扩张; ＴＡＶ股浅静脉〔（３．９０±２．３） ｃｍ ／ｓ ｖｓ （６．５０±２．２） ｃｍ ／ｓ〕和腘静脉〔（２．７５±２１） ｃｍ ／ｓｖｓ （５．７５±２．３） ｃｍ ／ｓ, Ｐ＜ ０．００１〕明显减慢。在Ｖａｌｓａｌｖａ＇ｓ或平静呼吸时显示有彩色返流信号, 脉冲多普勒显示呈双向频谱, 其中, 股浅静脉瓣３例, 腘静脉瓣１４例, 双瓣１９例。正常组腘静脉瓣１例。二组差别有极显著意义。结论　彩色多普勒超声能明确瓣膜的返流的部位及返流程度, 诊断下肢深静脉瓣功能不全。对外科合理地选择手术方式及部位, 并在术后观察疗效。     

丹参治疗糖尿病患者下肢动脉血流动力学研究

目的：用二维彩色多普勒超声（２Ｄ－ＣＤＩ）研究丹参治疗糖尿病患者后下肢股、、足背动脉血流动力学变化。资料与方法：１１例糖尿病患者，于丹参治疗前和治疗后一周内用ＨＰ１０００型彩超仪／７．５ＭＨｚ探头检测股、、足背动脉的内径（Ｄ）、收缩期血流峰值（ＰＥＶ）、舒张早期反向血流峰值（ＰＲＶ），舒张末期血流速度（ＥＤＶ），阻力指数（ＲＩ）、搏动指数（ＰＩ）等，并与正常组对照。结果：治疗后，患者股、动脉Ｄ稍变细，ＰＦＶ降低，ＰＩ略变大而足背动脉的ＲＩ略变小（Ｐ＞０．０５）。结论：丹参对治疗糖尿病动脉硬化、改善微循环有效。２Ｄ－ＣＤＩ可显示、评价下肢动脉血液动力学变化特点。     

彩色多普勒超声在下肢深静脉血栓形成诊断中的价值

目的 探讨彩色多普勒血流显像（ＣＤＦＩ）在下肢深静脉血栓形成（ＤＶＴ）诊断中的价值。方法 对８９例拟诊下肢ＤＶＴ患者在７１２条下肢静脉进行ＣＤＦＩ和静脉造影检查。结果 ＣＤＦＩ检出并经静脉造影证实的ＣＶＴ静脉共６４３例。ＣＤＦＩ的主要优点是：①节约时间,易于快速找至静脉;②对鉴别完全或不完全阻塞性血栓有一定帮助;③便于检查髂静脉血栓,尤其血栓髂总静脉蔓延时。ＣＤＦＩ和静脉造影在判断有无ＤＶＴ方面,     

下肢深静脉血栓二维彩色多普勒血流显像检查

目的 探讨二维彩色多普勒血流显像（２Ｄ－ＣＤＦＩ）诊断下肢深静脉血栓的价值。方法对可疑下肢深静脉血栓的４２例患者进行２Ｄ－ＣＤＦＩ检查。结果 ４２例４４条下肢深静脉有血栓形成（双侧２例,单侧４０例,发生于左侧３１例,右侧９例）。结论 ２Ｄ－ＣＤＦＩ能全面观察病变区管腔、管壁、管周结构及血流动力学状况,有利于疾病的定性诊断。     

彩色多普勒超声对下肢深静脉瓣功能不全的术前诊断价值

目的探讨二维超声及彩色多普勒血流显像(CDFI)技术在术前诊断下肢静脉瓣膜功能不全的应用价值。方法对43例患者59条下肢和50例正常对照组62条下肢的股浅静脉和静脉内径、瓣膜返流程度、返流持续时间进行测定。股静脉瓣膜功能做Valsalva试验,静脉瓣膜功能做立位或远端小腿挤压试验。结果正常对照组返流持续时间<0.7s。患肢深静脉瓣口及静脉内均显示部分及完全的反向彩色血流,多普勒频谱均显示为逆向和单向或双向频谱,持续时间均大于1s,静脉造影对照显示,病变组瓣膜返流时间较正常组显著延长(P<0.01)。结论超声检测下肢静脉瓣膜功能可根据病变的部位、性质和程度的不同,选择不同的手术方式,对临床诊断和手术方案的选择有实用价值。     

彩色多普勒超声评价下肢静脉倒流时间阈值的研究

目的：确定彩色多普勒超声评价下肢静脉倒流的时间阈值。方法：对40例准备行股浅静脉第一对瓣膜重建患者的肢体和15例自愿受检者20条正常肢体，应用彩色多普勒超声检测股浅静脉第一对瓣膜的倒流时间，检测的结果与手术中探查的结果相比较。结果：彩色多普勒超声以静脉倒时间0．5s作为判断静脉倒液的时间阈值具有较高的精确度（95％），结论：彩色多普勒超声探测静脉倒流的时间阈值定为0.5s较为客观，可靠。     

探讨下肢静脉瓣功能不全的二维彩色多普勒超声的声像图改变

目的：探讨下肢静脉瓣功能不全的二维彩色多普勒超声声像图改变。方法：应用二维彩色多普勒超声检查下肢静脉瓣功能不全９３例、１４２条腿,观察下肢静脉血管及瓣膜的解剖结构和血流动力学的改变。结果：有静脉瓣功能不全的患肢平均血流速度较健侧低Ｐ〈０．０５,患肢血管内径仅见大隐静脉较健侧明显增宽Ｐ〈０．０５,患肢深静脉内径与侧对比夫明显差别。结论：二维彩色多普勒超声能清楚显示下肢静脉血管的结构、血流状态、瓣膜有     

Quantitative Analysis of Helical Flow with Accuracy Using Ultrasound Speckle Image Velocimetry: In Vitro and in Vivo Feasibility Studies

Venous valve dysfunction and induced secondary abnormal flows are closely associated with venous diseases. Thus, detailed analysis of venous valvular flow is invaluable from biological and medical perspectives. However, most of the previous studies on venous perivalvular flows were based on qualitative analysis. On the contrary, quantitative analysis of perivalvular flows has not been fully understood. In this study, we used the ultrasound speckle image velocimetry (SIV) technique, which utilizes the speckle patterns of red blood cells (RBCs) created by ultrasound waves to measure 3-D valvular flows quantitatively. The flow structures obtained with the proposed SIV technique for an in vitro model were compared with those obtained by numerical simulation and the color Doppler method to validate the measurement accuracy of the ultrasound SIV technique. Blood flow in the human great saphenous vein was then measured at various distances from the valve with and without exercise. 3-D valvular flow was analyzed in accordance with the dimensionless index, helical intensity. The results obtained by the proposed method matched well with those obtained by numerical simulation and the color Doppler method. The hemodynamic characteristics of 3-D valvular helical flow which were analyzed experimentally using the SIV method would be used for quantitative diagnosis of venous valvular diseases.     

CDFI评价下肢深静脉瓣功能不全程度的方法再探讨

目的：探讨彩色多普勒超声在评价下肢深静脉瓣功能不全程度中的应用价值.方法：选取下肢深静脉瓣功能不全患者63例（患肢81条）,正常对照组24例（肢体48条）,进行下肢静脉彩色多普勒超声检查,观察第一对股浅静脉瓣的反流面积（RA）、反流时间（RT）、反流速度（RV）,根据静脉逆行性造影结果对下肢深静脉瓣功能不全进行分级.结果：与对照组比较,病例组股浅静脉瓣RA增大、RT延长,两组间差异有统计学意义（P＜0.05）;超声测量的股浅静脉瓣RA与下肢深静脉瓣功能不全程度呈高度相关性（r=0.998）,而RT、RV与反流程度相关性差（r=0.574、0.170）.结论：利用彩色多普勒超声所测量股浅静脉第一对瓣膜RA在评价下肢深静脉瓣功能不全程度中有意义,根据RA大小可以初步判断下肢深静脉瓣功能不全的程度.     

彩色多普勒超声心动图对双腔右心室的诊断价值

目的回顾探讨彩色多普勒超声心动图在双腔右心室中的诊断价值。方法21例经手术证实的双腔右心室患儿，回顾术前二维及彩色多普勒超声检查，内容包括肥厚肌束部位、形态、合并畸形及右心血流信息与心腔内压力变化。结果右室窦部与漏斗部之间可见异常肥厚肌束；异常肌束交通口处可检测到收缩期高速湍流频谱；21例中合并室间隔缺损18例(85．7％)，肺动脉瓣狭窄2例(9．5％)。结论彩色多普勒超声心动图诊断双腔右心室及其合并畸形直接、安全、快捷，具有重要的临床价值。     

下肢静脉溃疡的血流动力学检测

目的：检测下肢静脉溃疡的血流动力学并探讨其临床价值。方法：应用彩色多普勒血流显像（ＣＤＦＩ）或彩色能量图（ＣＰＡ）对我住院患者４３例４８肢５９个静脉溃疡进行血流动力学检测。结果：浅静脉返流（９６％）在静脉溃疡形成及发展中有直接作用,静脉溃疡周围的交通支返流（５８％）有一定的影响,但深静脉返流（５６％）特别有静脉返流也必须重视,约３１％的静脉溃疡有联合形式的静脉血流动力学异常。在行浅静脉及交通支静脉手术的同时行深静脉重建术是非常必要的。结论：彩超能详细了解各静脉系统及其每个静脉段的血流动力学状况,不仅可提供静脉的解剖信息,且可提供其功能信息,目前已成为评价下肢静脉血流动力学的主要工具之一。     

Image-directed Doppler ultrasound in the diagnosis of lower-limb venous insufficiency

Ninety-eight legs in 73 patients were evaluated with image-directed Doppler ultrasound for suspected chronic venous insufficiency. Examinations of the entire venous system were performed to determine lumen patency and valvular competence. Reflux during Valsalva maneuver in the femoral and great saphenous vein, and, after release of distal compression in the popliteal vein, indicated valvular incompetence. Twenty limbs had normal veins; Baker's cysts were found in three. Superficial venous insufficiency was found in 25 cases. Deep reflux, either alone or in combination with superficial reflux, was the predominant pathological feature (53 legs). Photoplethys-mographic studies of the veins were performed on 24 limbs. Image-directed Doppler ultrasound was more successful in defining the exact site of venous incompetence and in detecting nonvenous pathology. By the combination of real-time imaging of the vein with gated Doppler sonography of flow, image-directed Doppler sonography is becoming the method of choice for the investigation of chronic venous insufficiency. © 1994 John Wiley & Sons, Inc.     

Transient global amnesia: cerebral venous outflow impairment-insight from the abnormal flow patterns of the internal jugular vein

Cerebral venous reflux is found frequently in transient global amnesia (TGA) patients. The cerebral venous reflux mostly results from left brachiocephalic venous obstruction, and the level of reflux depends on different respiratory status. For further understanding of the role of venous outflow impairment in the pathogenesis of TGA, we used color duplex sonography to reveal the flow patterns in the internal jugular vein (IJV) and its branches (JB) under different respiratory conditions. We compared the frequency of abnormal venous flow of IJV and/or JB on color duplex sonography between 17 TGA patients and 17 age- and gender-matched normal individuals both at rest (regular breathing) and at deep inspiration. Further, these venous-flow abnormalities in IJV and JB were well described. Cranial 3-D time-of-flight magnetic resonance arteriography (MRA) were performed in all patients three to seven days after their TGA attacks and in all normal individuals to analyze the abnormal flow signals in the intracranial venous structures. In the result, abnormal flow-patterns in the left IJV and/or left JB during regular breathing were found more frequently in TGA patients than normal individuals (65% vs. 6%; p < 0.001). These abnormalities in TGA patients were (1) isolated reversed flow in the left JB, (2) segmental reversed flow in the left distal IJV and (3) continuous reversed flow in the left IJV and JB. The MRA study revealed that only the most severe reflux in the IJV causes intracranial venous reflux; six were in the group of continuous reversed flow in left IJV and one was in the group of segmental reversed flow in left distal IJV. These findings suggest that TGA might be one of the clinical manifestations of the "cerebral-type intermittent venous claudication," which stems from cerebral venous outflow impairment, insufficient venous collaterals and specific precipitating factors.     

Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation.

OBJECTIVE: To determine the spectrum of sonographic findings on gray scale and color Doppler sonography in a series of pathologically proven cases of ovarian and adnexal torsion. METHODS: The study population included 15 patients with surgical confirmation of ovarian or adnexal torsion, or both, who underwent sonographic examination before surgery. All sonograms were reviewed retrospectively. RESULTS: Gray scale abnormalities included the following: complex masses in 11 (73%) of 15 patients, cystic masses in 3 (20%), and a solid mass in 1 (7%). Cul-de-sac fluid was present in 13 (87%) of 15 patients. Adnexal neoplasms were present in 4 (27%) of 15 (1 granulosa cell tumor and 3 dermoid cysts) on pathologic examination. Doppler findings were abnormal in 14 (93%) of 15 patients and normal in 1 (7%). Abnormal Doppler findings included no arterial and no venous flow in 6 (40%) of 15, decreased venous flow with no arterial flow in 5 (33%), decreased venous flow and decreased arterial flow in 2 (13%), and decreased arterial flow with no venous flow in 1 (7%). Small amounts of cul-de-sac fluid were present in 13 (87%) of 15 patients. CONCLUSIONS: The diagnosis of ovarian and adnexal torsion remains challenging. It cannot be based solely on the absence or presence of flow on color Doppler sonography, because the presence of arterial or venous flow does not exclude the diagnosis of adnexal torsion. Comparison with the morphologic appearance and flow patterns of the contralateral ovary will aid in diagnosis.