经阴道彩色多普勒对生育期子宫血流的研究

目的　建立生育期子宫各段动脉血流参数的正常参考值范围。方法　应用经阴道彩色多普勒超声观察 66例正常生育期子宫动脉 (UTA)、弓状动脉 (AA)、放射动脉 (RA)、螺旋动脉 (SA)的收缩期峰值流速 (PSV)、舒张末期流速 (EDV)、搏动指数 (PI)、阻力指数 (RI)和收缩 /舒张末流速比 (S/D) ,并进行统计分析。结果　生育期子宫各段动脉均能良好地显示 ,从子宫动脉到螺旋动脉各血流参数呈不同程度的降低 ;在月经周期中 ,螺旋动脉于分泌期呈低阻高流速的改变最为显著。结论　生育期子宫血流动力学参数的改变与月经的周期性变化密切相关 ;通过测定螺旋动脉阻力指数 ,可预测月经周期的时相     

Doppler and gray-scale ultrasound evaluation of morphological and hemodynamic changes in liver vascualture in alcoholic patients

OBJECTIVE: The aim of this study is to search sonographically for morphological and hemodynamic changes in hepatic and splanchnic vasculature of alcoholic patients having no signs of hepatic damage, and compare these with normal healthy subjects. METHODS: Thirty alcohol-dependent patients and 30 control subjects with no alcohol problem or hepatic impairment were included in the study. All patients were evaluated by gray-scale and spectral Doppler ultrasound. The diameter of the portal vein, portal venous velocity, peak systolic and end diastolic velocities of hepatic and superior mesenteric arteries were assessed. RI, PI and systolic/diastolic velocity ratios were also calculated. RESULTS: Portal vein cross-sectional area was greater in alcoholic patients compared to control group (P = 0.0012). Portal vein velocity, hepatic artery peak systolic and end diastolic velocity, superior mesenteric artery peak systolic and end diastolic velocity were significantly greater in alcoholic patients than in control group (P < or = 0.001). No statistically significant difference was detected between other parameters evaluated. CONCLUSION: In alcohol-dependent patients, some hemodynamic and morphologic changes occur in hepatic and splanchnic circulation, even before the signs of hepatic damage develop. These changes can be detected by means of Doppler and gray-scale sonogrsphy.     

能量多普勒对正常胎儿大脑中动脉阻力参数的检测分析

目的：了解正常胎儿大脑中动脉（middle cerebral artery,MCA）搏动指数（pulsatility index,PI）、阻力指数（re-sistance index,RI）、收缩期峰值流速与舒张末期流速比值（S/D）的正常参考值范围。方法：应用能量多普勒及脉冲多普勒检测2436例孕16～40周无合并症单胎孕妇,测量胎儿MCA的PI、RI、S/D值并进行分析。结果：胎儿MCA阻力参数指标双侧对比无显著性差异,MCA血流阻力在16～28周时随孕周增加而增高,在孕28～30周时达高峰,孕30周以后随着孕周增加而下降。结论：本文数据可作为正常胎儿MCA血流阻力正常值参考,了解正常胎儿MCA血流阻力在不同孕周的变化规律,对胎儿生长发育的临床监测具有重要意义。     

胎儿肾血管彩色多普勒检测

本文报道了应用彩色多普勒超声显像仪对４６例胎儿肾动脉血流的测定结果。胎儿肾动脉血流在发育不同阶段呈规律的变化：Ｖｓ、Ｖｄ、Ｔａｍｘ、ＣＴＩ随胎龄的增加呈递增趋势，Ｖｓ／Ｖｄ随胎龄增加呈递减趋势，Ｖｓ反映肾动脉血流量，Ｖｄ反映肾动脉血管阻力，ＰＩ、ＲＩ在各胎龄期无明显差异。结果表明：应用多普勒超声检测胎儿肾动脉血流来评价胎儿周围循环状态，预测胎儿的发育情况是可行的，并且是可靠的。     

Correlation of femoral artery flow velocity waveform with ipsilateral iliac artery stenoses assessed with magnetic resonance imaging

Background: Magnetic resonance (MR) permits quantitative flow velocity measurements that could be used to detect changes in the curve profile downstream of a high-grade stenosis.

Purpose: To assess whether MR flow measurements can be used to detect iliac artery stenoses.

Material and Methods: Contrast-enhanced magnetic resonance angiography (MRA) and quantitative flow measurements in the lower aorta and proximal femoral arteries were performed in 29 patients with suspected iliac artery stenoses. Stenoses were graded into five degrees: 0%, 1-49%, 50-74%, 75-99%, and 100% diameter reduction. The femoral artery waveforms were evaluated qualitatively by two independent reviewers regarding peak systolic velocity (PSV), aortofemoral difference in time-to-peak (ΔTTP), systolic acceleration (SA), curve-shape index (CSI), and the presence of an early diastolic flow reversal. The correlation between these parameters and the degree of stenosis was assessed.

Results: A significant correlation with degree of stenosis was observed for the qualitative flow waveform evaluations, with a high degree of interobserver agreement (κ = 0.84). A significant correlation was also found between degree of stenosis and PSV, ΔTTP, SA, CSI, and presence of diastolic flow reversal. The flow velocity pattern, however, remained unchanged, both qualitatively and quantitatively, up to a stenosis degree of at least 75%.

Conclusion: Iliac artery stenoses cause femoral artery flow waveform changes that can be detected with MRI, but only at high-grade levels.     

Distal arterial flow in patients undergoing upper extremity dialysis shunting: a prospective study using doppler sonography

OBJECTIVE: The objective of this study was to document changes in the distal circulation after creation of a proximal upper extremity dialysis shunt and to correlate these findings with the patient's clinical condition. SUBJECTS AND METHODS: We prospectively examined 18 patients scheduled for upper extremity shunt creation. We used color and spectral Doppler sonography to examine flow in the radial and ulnar arteries, noting flow direction and peak systolic velocity. After the shunt procedure, we repeated the measurements and correlated them statistically with hand symptomatology. RESULTS: Six (33%) of 18 patients were symptomatic. The mean peak systolic velocities in the radial and ulnar arteries were 52 and 61 cm/sec, respectively, before surgery, and decreased to 12 cm/sec after surgery in the radial artery and 44 cm/sec in the ulnar artery. The mean percentage of decrease in peak systolic velocity was 77% in the radial artery and 28% in the ulnar artery. Eight patients showed reversed flow. No statistical correlation was found between change in peak systolic velocity values before and after surgery and the presence of hand symptoms. Similarly, no correlation was found between flow reversal and symptoms. The most consistent factor associated with symptoms was diabetes; all symptomatic patients were diabetic, but only 54% of the diabetic patients were symptomatic. CONCLUSION: The difference in the peak systolic velocities in the radial and ulnar arteries after shunt construction does not correlate with symptoms. The hand can tolerate a significant decrease in the peak systolic velocity and even flow reversal without symptomatology.     

Duplex Doppler analysis of interlobular arteries in transplanted kidneys

The aim of our study was to analyze changes in spectral Doppler waveforms between interlobar and interlobular arteries in renal transplants and to determine whether sampling location at interlobular level can be suitable for intrarenal resistive index (RI) measurements. Paired series of spectral tracings from interlobar arteries and respective interlobular branches were obtained in 62 consecutive renal transplants at 6.5-MHz Doppler frequency. The values of peak systolic velocity (PSV), end diastolic velocity (EDV) and RI were significantly (P < 0.01) reduced when calculated at interlobular level. In 38 % of cases, an interlobar RI higher than 0.70 corresponded to a normal interlobular RI. The values of PSV, EDV, and RI did not differ significantly at interlobular level between allograft subsets with normal and elevated serum creatinine level. Both intra- and interobserver variation were higher at interlobular than at interlobar level when performing the RI. During a conventional study of renal vasculature, an underestimation of abnormal RI findings can be expected from the incidental evaluation of interlobular tracings. We recommend sonologists to pay attention in accurately locating the sample volume at interlobar–arcuate level when evaluating intrarenal RI. Received 30 December 1996; Revision received 16 May 1997; Accepted 3 September 1997     

兔肾缺血-再灌注损伤后叶间动脉血流动力学变化与肾小管上皮Bcl-2表达的相关性

目的 探讨兔肾缺血-再灌注损伤后叶间动脉血流动力学变化及其与肾小管上皮Bcl-2表达的相关性.材料与方法 建立兔肾缺血-再灌注损伤模型,采用彩色多普勒血流显像(CDFI)和脉冲多普勒(PW)检测缺血-再灌注组(I/R组,n=24)兔和假手术组(S组,n=24)兔恢复血流后2h、8h、24h肾叶间动脉血流参数,包括收缩期峰值流速(Vmax)、舒张末期流速(Vd)、时间平均峰值流速(Tamax)、搏动指数(PI)和阻力指数(RI);以HE染色分析肾组织病理损伤程度;采用免疫组化SABC法检测肾小管上皮细胞中Bcl-2蛋白表达水平.结果 I/R组在2h时较S组无明显血流动力学改变,随着缺血-再灌注时间J延长,Vmax、PI、RI逐渐增大,24h时达高峰,其中RI24h较8h差异有统计学意义(P＜0.05);病理切片显示I/R组24h时肾小管上皮细胞坏死脱落程度最重;S组Bcl-2蛋白呈弱阳性表达,随着缺血-再灌注时间推移而逐渐上升,24h达高峰;叶间动脉Vmax、PI、RI与Bcl-2表达呈显著正相关(r=0.572、0.416、0.647,P＜ 0.05).结论 在兔肾缺血-再灌注中,肾叶间动脉血流动力学变化与肾小管上皮Bcl-2表达呈明显正相关,彩色多普勒超声对评价兔肾缺血-再灌损伤程度有较高价值.     

Renal allografts: prospective analysis of Doppler sonography

Fifty-six consecutively transplanted renal allografts were prospectively evaluated with serial Doppler sonographic examinations. Thirty-eight episodes of transplant rejection in 32 patients (63% proved pathologically) and 24 episodes of acute tubular necrosis (ATN) in 24 patients were encountered. The Doppler spectral waveform was characterized by means of the pulsatility index (PI), systolic/diastolic ratio (SDR), diastolic/systolic ratio (SDR), diastolic/systolic ratio (DSR), and resistive index (RI). Accuracy was optimized with use of top normal values as follows: PI = 1.8, SDR = 4.0, DSR = 0.25, RI = 0.75. There were no significant differences in the indices for those patients undergoing rejection versus those with ATN. The sensitivity for predicting transplant rejection was adversely affected by the history of either ATN or a previous rejection episode in the same allograft. Comparison with concurrent radionuclide examinations revealed similar sensitivities for rejection with scintigraphy and sonography. Differentiation of ATN from rejection was more reliable with scintigraphy than with sonography.     

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     

飞行职业对飞行人员脑动脉弹性指标的影响分析

目的探讨飞行职业对飞行员的脑动脉弹性指标及血流动力学的影响。方法现役飞行员125名,平均年龄为（32．26±4．47）岁,对照组为89名健康志愿者,平均年龄为（29．80±7．58）岁。采用经颅多普勒超声技术分别观察受试者大脑前、中、后动脉、椎动脉及基底动脉的收缩期峰值流速（systolic velocity,Vs）,舒张期流速（diastolic velocity,Vd）,平均血流速度（mean velocity,Vm）及搏动指数（pulsitility index,PI）和血管阻力指数（resistance index,RI）。以年龄为协变量,对数据进行协方差分析。结果飞行员组的大脑前、中、后动脉、椎动脉及基底动脉的Vs、Vd、Vm及PI与对照组同侧相比,均无差异（P〉0．05）;但飞行员组的左侧大脑前动脉的RI值低于对照组人群[P=0．0464,（0．527±0．005）vs（0．542±0．006）]。结论飞行职业对飞行员的脑血流参数无明显影响,但飞行职业能提高飞行员脑血管调节能力,提高血管顺应性。     

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     

孕早期血清胎盘生长因子、妊娠相关蛋白-A、β-人绒毛膜促性腺激素检测联合子宫动脉血流参数对子痫前期预测价值研究

目的 探讨孕早期血清胎盘生长因子(PLGF)、妊娠相关蛋白(PAPP)-A、β-人绒毛膜促性腺激素(HCG)检测联合子宫动脉血流参数对子痫前期的预测价值.方法 将沈阳市第五人民医院自2018年1月至2019年6月收治的41例孕早期(孕9周～孕13+6周)子痫前期孕妇纳入B组,将同期本院产检建档且未确诊为子痫前期的82例...     

Reference values for Doppler ultrasound parameters of the thyroid in a healthy iodine-non-deficient population

The aim of this study was to describe normal Doppler parameter values in the thyroid arteries in an iodine-replete region. 165 individuals were randomly selected in a community located in the south-east of Brazil. We obtained a clinical history on each subject and determined serum thyrotropin, antiperoxidase antibodies, thyrotropin receptor antibody (TRAb) and thyroid volumes through ultrasound. Subjects with thyroid disease and those under 20 years of age were excluded. 84 representative subjects (30 men and 54 women) remained. The systolic peak velocity (SPV), resistive index (RI) and pulsatility index (PI) in the superior and inferior thyroid arteries were measured using a 5-12 MHz linear probe. Except for the RI, the distribution of all Doppler parameters was non-gaussian. The median and mean references for the SPV, RI and PI were 24.80 cm s(-1) and 25.85 cm s(-1), 0.60 and 0.62, and 0.98 and 1.04, respectively, for superior thyroid arteries; these reference values for the inferior thyroid artery were 20.92 cm s(-1) and 21.50 cm s(-1), 0.57 and 0.57, and 0.84 and 0.88, respectively (p<0.001). Women had greater SPV values (p<0.01). We have determined reference thyroid Doppler parameter values in our iodine-non-deficient population and prepared tables by sex and age.     

Study of normal Chinese vertebral-basilar arteries with transcranial color Doppler flow imaging

OBJECTIVE: The aim of this study was to evaluate the blood flow characteristics of intracranial vertebral-basilar artery (V-BA) in healthy Chinese adults with transcranial color Doppler flow imaging (TCDFI) and provide reference values of healthy people of different ages and genders. METHODS: Three hundred healthy Chinese adults were divided into three groups based on their ages: Group I: 20-39 years, Group II: 40-59 years, Group III: >/=60 years. Each group was subdivided into two subgroups according to their gender. Peak systolic velocity (Ps), end-diastolic velocity (Vd), time average maximum velocity (TAMAX), pulsatility index (PI), and resistance index (RI) were measured from intracranial V-BA scanning. RESULTS: Ps, Vd, and TAMAX decreased with age, while PI and RI increased in all groups. Flow velocity in women was slightly higher than that of men, and there was significant differences in group III between men and women (P<.05). However, no difference was found in the flow parameters between left and right vertebral arteries. CONCLUSIONS: This study offered reference values of intracranial V-BA flow parameters in healthy Chinese adults and indicated that these parameters varied with age and gender.     

Variability of ultrasonography velocity assessment of the carotid arteries

PURPOSE: To assess the intraobserver variability of echoDoppler sonographic measurement of various carotid arteries parameters. Materials and methods: Repeated bilateral carotid examinations were performed in ten healthy subjects, using three color-coded duplex ultrasound systems (two Acuson 128 XP, one ATL HDI 3000) and different linear probes. Each examination included two successive sets of measurements. RESULTS: The resistive index values decreased from the proximal common carotid artery to the distal common carotid artery (p <10(-7)). According to the set of measurements and to the equipments considered, the range of mean absolute differences of the systolic peak velocity (PSV), the end diastolic velocity (EDV) values, the ICA/CCA PSV and PSV/EDV velocity ratios and the resistive index (RI) values were 8-16cm/s, 3-6cm/s, 0.08-0,15 and 0. 16-0.26, and 0.02-0.06 respectively. Standard deviations of the proportional differences of the RI and PSV measurements averaged respectively 6% and 15% and were always reduced by repeating the measurements. The use of similar ultrasound machines was not associated with a reduced variability. CONCLUSION: The substantial variability of Doppler measurements in carotid arteries, even with the use of the same operator and similar machines could be reduced using "angle independent" parameters.     

Differentiation between the two types of amiodarone-associated thyrotoxicosis using duplex and amplitude Doppler sonography

Purpose: To evaluate the usefulness of Doppler parameters in the differentiation between the two types of amiodarone-associated thyrotoxicosis (AAT). Material and Methods: One hundred thirty-seven individuals were selected at our institution. They were divided into four groups: 84 normal subjects (N), 30 euthyroids taking amiodarone (A), 14 AAT type 1 patients (AAT1), and nine AAT type 2 patients (AAT2). Each AAT type was classified according to (131)I uptake and clinical outcome. Blindly, the resistance and pulsatility indexes (RI, PI), systolic peak velocity, and color pixel density (CPD) were calculated. Results: AAT1 had greater CPD than AAT2 (P = 0.02). The latter group had similar vascularization to the N and A groups (P = 0.45). The area under the receiver operating characteristic (ROC) curve showed that systolic peak velocity in the inferior thyroid arteries and CPD were the best parameters in the differentiation between AAT type 1 and AAT type 2 (Az = 0.83 and 0.84, respectively). Impedance indexes were useless. Conclusion: Our results demonstrate that objective tests such as systolic peak velocities in the thyroid arteries and CPD are reliable parameters for differentiating between the two types of AAT.     

正常晚孕期胎儿大脑中动脉血流的彩色多普勒超声表现

目的：建立晚孕期正常胎儿大脑中动脉血流动力学参考范围。方法：应用彩色多普勒超声经胎儿大脑外侧裂层面检测80例孕28周-孕41周正常胎儿大脑中动脉血流波形,并测定血流参数：收缩期峰值流速Vp,舒张末期流速Ed,搏动指数PI,阻力指数RI。结果：正常胎儿大脑中动脉血流动力学各项参数随孕周增加而增加。结论：超声对于检测胎儿脑血流具有简便和可重复性好的优点。产前监测胎儿大脑中动脉血流不仅为胎儿期脑循环提供理论依据,而且可为研究胎儿出生后大脑中动脉血流动力学变化及缺血缺氧性脑病的血流动力学改变奠定基础。     

Evaluation of normal erectile function with color flow Doppler sonography

To understand better the vascular events that occur during normal erection, we used color flow Doppler sonography to examine the erectile process in seven normal subjects. The relationship of systolic/diastolic velocities and spectral waveform changes in the penile arteries was studied in response to increasing pressure within the corpora cavernosa (tumescence) before and after the intracorporal administration of drugs to induce erection. A characteristic spectral waveform pattern was identified throughout the erectile cycle, and the pattern was correlated with increasing pressure. Both systolic and diastolic velocities were elevated during the initiation of erection, at which time the pressure within the corpora cavernosa was low (11-25 mm Hg). Systolic velocities remained elevated until the last phase of erection (83-106 mm Hg). Diastolic velocity decreased as the intracorporal pressure increased from 25 to 40 mm Hg. Between 40 and 63 mm Hg, diastolic velocity approximated zero. With increasing pressure (63-83 mm Hg), diastolic flow reversed. As the corpora cavernosa approached full erection (83-105 mm Hg), both the forward systolic and reverse diastolic flow components diminished. At approximately 106 mm Hg (systolic occlusion pressure), flow ceased. Systolic/diastolic velocity and waveform phase relationships could be used to define the integrity of both the cavernosal artery inflow and the venous sinusoidal outflow occlusion mechanisms. Color flow Doppler sonography enhanced our ability to observe and quantify dynamic erectile events and provided new insights into understanding normal erectile function.