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     

彩色多普勒超声对高度近视眼后巩膜改变相关因素的评价

目的:探讨高度近视眼后巩膜形态改变与眼轴长度、近视程度及血流动力学变化之间的关系。方法:应用ATL超9型APOOGE-800型彩色多普勒超声诊断仪,探头频率5.0~10.0MHz。对26例正常眼,36例轻中度近视眼,51例高度近视眼后巩膜进行观察。并对26例正常眼,17例轻中度近视眼,26例高度近视眼的眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)进行检测。结果:轻中度近视组、高度近视组的眼轴长度与近视程度呈正相关性。两者之间的直线回归方程Y=-3510.3 1668.1X,R=0.9432,P<0.0001。后巩膜形态改变与正常对照组比较差异有显著性意义(P<0.001)。高度近视眼组、轻中度近视组与正常对照组比较,OA血流参数差异无显著性意义(P>0.05),而高度近视组的CRA、PCA的收缩期(PSV)、舒张期(EDV)、平均血流速度(AV)均减低,CRA的阻力指数(RI)升高(P<0.05)。轻中度组与对照组比较差异无显著性意义(P>0.05)。结论:视网膜血管、睫状血管系统血供不足与后巩膜形态变化的类型、眼轴长度、近视的程度及血流动力学改变密切相关,是引起高度近视眼病理性眼底改变发生和发展的重要因素。     

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。     

失代偿期肝硬化CT显示腹膜和腹膜后组织水肿的临床意义

目的　探讨失代偿期肝硬化腹膜和腹膜后水肿CT表现特点及临床意义。方法　 44例经临床和实验室检查证实为失代偿期肝硬化 (DCC)。根据腹膜和腹膜后水肿的范围 ,分为轻、中、重3级 ,并观察腹水及其量和静脉曲张的情况。将上述指标与血清白蛋白 (ALB)和透明质酸 (HA)水平进行相关分析。结果　腹膜和腹膜后水肿的程度与血清ALB降低的程度 (rs=0 70 88,P <0 0 0 1)、血清HA升高的程度 (rs=0 5 2 94,P <0 0 1)和腹水量 (rs=0 5 44 0 ,P <0 0 0 5 )有明显的相关性。而与静脉曲张形成无相关性 (rs=0 1335 ,P >0 .0 5 )。结论　DCC病人CT显示腹膜和腹膜后水肿 ,在一定程度上可反映肝硬化病变的程度。     

视网膜中央静脉阻塞与球后血流动力学及血液流变学的临床分析

 目的探讨视网膜中央静脉阻塞(CRVO)患者的视网膜中央动脉(CRA)、眼动脉(OA)的血液动力学、血液流变学改变及其相互关系.方法采用美国AcusN128XP/10彩色多普勒成像(CDI)技术检测33例CRVO患者和33例正常人CRA.OA血流动力学及血液流变学改变.结果CRVO患眼CRA收缩期最大血流速度(Vmax)比对侧眼(P＜0.05)及对照组(P＜0.01)下降,舒张末期最小血流速度(Vmin)比对侧眼及对照组减低(P＜0.05),阻力指数(RI)比对侧眼(P＜0.05)及对照组(P＜0.01)增高.低切率全血比粘度较对照组显著性增高(P＜0.01),并与CRAO患者Vmax(r=-0.641,P＜0.01)、Vmin(r=-0.538),P＜0.01)成负相关.结论CRVO患眼CRA的CDI参数异常,表明动脉血流速度的下降与CRVO发病相关,CRA供血减少是引起视网膜损害的主要原因之一.低切率全血比粘度增高是导致CRVO患眼CRA血流下降因素之一.     

眼底动脉彩超血流参数对糖尿病患者视网膜病变程度的评估价值

目的探讨眼底动脉彩超血流参数对糖尿病患者视网膜病变程度的评估价值。方法收集我院进行治疗的糖尿病患者64例,根据患者视网膜是否发生病变,将患者分为观察组和对照组,其中观察组患者为糖尿病伴视网膜病变,观察组患者为糖尿病不伴视网膜病变。分别对两组患者做眼底动脉彩超影像学检查,测量患者眼动脉(OA)、视网膜中央动脉(CRA)和睫状动脉(PCA)三动脉的血流参数并进行分析对比。结果两组患者相比,OA、PCA和CRA三大动脉的血流参数,观察组眼动脉参数Vs(收缩期血液峰值)、Vd(舒张期后期血液流速)明显低于对照组,差异有统计学意义(P0.05),其RI(阻力指数)与PI(搏动指数)均表现不同程度的升高,与对照组比较,差异有统计学意义(P0.05)。结论使用眼底动脉彩超的动态影像学方式检查患者眼血流动力学参数,对于糖尿病患者视网膜病变程度具有一定的评估价值。     

多b值弥散加权成像对乙肝肝硬化分级的诊断价值探讨

目的探讨乙肝肝硬化患者不同肝叶磁共振弥散加权成像不同b值对肝硬化Child-Pugh分级的诊断价值。方法收集72例乙肝肝硬化患者和23例健康志愿者,其中肝硬化患者按Child-Pugh评分系统分为A、B、C三组分别为22例、26例和24例,均行肝脏MR-DWI扫描,设定不同的弥散敏感系数(b值)分别为0s/mm2、400s/mm2、600s/mm2、800s/mm2,测定每个受试者不同b值下肝脏各叶的ADC值。分别统计各b值肝左外叶、肝左内叶、肝右叶和肝尾状叶的ADC值,分析不同肝叶ADC值与Child-Pugh分级的相关性,使用ROC曲线评估肝叶ADC值对肝硬化分级的诊断效能。结果在不同b值下,肝硬化组肝脏ADC值均低于正常对照组,且各肝叶ADC值与肝硬化Child-Pugh分级均呈负相关(P0.05)。结论 DWI可以对乙肝肝硬化进行定量检查,有助于临床早期无创伤性评估肝硬化分级。     

声脉冲辐射力成像联合肝固有动脉血流动力学评估肝硬化程度

目的:探讨声脉冲辐射力成像(ARFI)联合肝固有动脉血流动力学评估肝硬化程度的价值.方法:选取135例肝硬化患者为观察组,按照Child-Pugh(CP)评分对患者肝硬化程度进行分级;选取50例健康志愿者作为对照组.检测所有研究对象(观察组和对照组)的肝固有动脉血流动力学指标,包括收缩期峰值流速(PSV)和阻力指数(RI),并进行ARFI检查,测量肝实质硬度值(LS).分析不同CP评分分级的LS值、PSV及RI,采用受试者工作特征(ROC)曲线分析LS值与PSV、RI单用或联合应用对肝硬化的诊断价值.结果:观察组CP评分A、B、C三级患者的LS值、PSV及RI值均明显高于对照组,且C级＞B级＞A级,差异均具有统计学意义(P＜0.05).CP评分与LS值、PSV及RI均呈显著正相关(r=0.727、0.683、0.608,P值均＜0.05).LS值与PSV、RI联用的ROC曲线下面积高于单个指标.结论:ARFI检测的LS值联合肝固有动脉血流动力学指标对评估肝硬化程度具有重要价值.     

甲亢突眼征眼部动脉血流频谱特征和血流动力学研究

目的:探讨甲亢突眼征眼部动脉血流频谱特征和血流参数变化的规律,及与眼轴、眼压等的关系。方法:应用彩色多普勒超声诊断仪对甲亢突眼征患者(31例,62只眼)和正常人(25例,50只眼)的眼动脉(OA)、睫状后短动脉(SPCA)、视网膜中央动脉(CRA)的收缩期峰值流速(PSV)、舒张期最小流速(EDV)和阻力指数(RI)以及眼轴等进行检测。结果:①6项超声指标中,甲亢突眼组与正常对照组比较,眼轴、球横径无显著性差异(P>0.05);球尖距、球后软组织周长、球后软组织面积及球后软组织体积差异显著(P<0.05或<0.01)。②甲亢突眼征眼部动脉频谱形态OA第一峰高尖,第二峰降低圆钝,甚至出现两峰融合,峰时延长、后移;SPCA第一峰增高且宽大,第二、三波峰圆钝,峰时后移;CRA第一峰上升速度明显加快,波峰较高,而第二峰峰时延长、后移。③眼部血流动力学变化特点为:甲亢突眼组与正常对照组比较OA、SPCA和CRA的PSV均明显增高(P<0.01),EDV和RI有显著性差异(P<0.05,P<0.01)。结论:甲亢突眼征眼部血流频谱形态特征、血流动力学参数和球尖距、球后软组织周长、球后软组织面积及球后软组织体积发生改变。     

肝动脉阻力指数与肝移植术后胆道并发症的相关性分析

目的:通过彩色多普勒超声检测肝动脉阻力指数变化,评价其对肝移植术后胆道并发症的预测价值.方法:用彩色多普勒超声观察107例肝移植患者术后肝脏血流变化,将肝动脉阻力指数进行分类分析.结果:肝移植术后,发生胆道并发症者33例.出现低阻力指数者共44例,包括首次检查RI≤0.50、随访2次以上发现RI≤0.50及RI较首次检查降低>0.30者,其中30例术后发生胆道并发症.低阻力指数者胆道并发症发生率明显增高(P<0.01),阻力指数正常者胆道并发症发生率明显减低(P<0.01),高阻力指数者胆道并发症发生率与整体发生率差异无统计学意义(P>0.05).结论:肝动脉低阻力指数与胆道并发症有明显的相关性,超声可预测肝移植术后肝动脉供血不足导致的胆道并发症.     

彩色多普勒超声对缺血性视乳头病变早期血流动力学的研究

目的:探讨缺血性视乳头病变早期患者眼血流动力学变化。材料和方法:应用彩色多普勒血流成像(CDFI)技术检测40例患者与36例健康志愿者眼动脉、视网膜中央动脉、睫状后动脉收缩峰值速度(PSV)、舒张末期流速(EDV)、阻力指数(RI)及视网膜中央静脉最大流速(Vmax)。结果:与正常组比较,患者组眼动脉PSV无显著差异(P>0．05), EDV减低、RI增高(P<0．05);视网膜中央动脉PSV、EDV减低,RI增加(P<0．05);睫状后动脉PSV、EDV明显减低, RI明显增加(P<0．01);视网膜中央静脉Vmax减低(P<0．05)。结论:CDFI可评估缺血性视乳头病变早期眼血流动力学变化,为临床提供诊断信息。     

彩色多普勒对糖尿病患者眼底血管血流动力学研究

目的:研究糖尿病患者眼底血管的血流动力学改变。方法:采用彩色多普勒技术对30例正常人和90例糖尿病患者视网膜中央动脉(CRA)、视网膜中央静脉(CRV)和眼动脉(OA)的血流参数进行检测。结果:糖尿病患者CRA血流速度较对照组降低(P<0.05),以舒张期末血流速度(Vd)降低为显著(P<0.01),阻力指数(RI)比对照组增高(P<0.05);CRV血流速度较对照组升高(P<0.05),CRA/CRV比值降低;OA收缩期峰值血流速度(Vs)和舒张期末血流速度(Vd)比对照组均降低(P<0.05),以Vd降低明显(P<0.01),RI比对照组显著增高(P<0.01)。糖尿病合并增殖性视网膜病变的患者(C组),收缩期峰值血流速度(Vs)、平均血流速度(Vmean)比糖尿病无视网膜病变患者(A组)降低(P<0.05)。结论:糖尿病患者眼底血管的血流动力学异常,对糖尿病视网膜病变的早期诊断、防治有重要意义。     

Colour Doppler ultrasound evaluation of orbital vessels in diabetic retinopathy

The aim of this study was to determine the role of colour Doppler imaging in the retrobulbar vascular circulation in diabetic retinopathy (DR). Maximum (V(max)), end-diastolic (V(min)) and average (V(mean)) velocities of blood flows and pulsatility index and resistivity index (RI) in central retinal artery (CRA), short branches of posterior ciliary artery (PCA) and ophthalmic artery of the 65 diabetic and 22 control eyes were measured. The CRA V(max) level in the control group was significantly higher than in DR groups. The CRA V(mean) level was also significantly higher in the control group than in the mild nonproliferative diabetic retinopathy (NPDR) and the moderate NPDR groups. The CRA RI value was significantly higher in the control group than in the nonretinopathy group. The CRA V(min) and the ophthalmic artery RI values were found significantly higher in the nonretinopathy group than in the moderate NPDR group. There were significant decreases in the some CRA and PCA values as glycated haemoglobin (HbA1c) levels increase in diabetic group. There was a positive correlation between the duration of diabetes and HbA1c levels. This study showed the presence of some dynamic circulatory alterations in the nonretinopathy group with diabetes and DR groups. It was also shown that there is a negative correlation between HbA1c and some orbital vascular velocities.     

Changes in cerebral and ocular hemodynamics in Behçet's disease assessed by color-coded duplex sonography

AimTo quantify the cerebral and retrobulbar hemodynamics in Behçet's disease with and without ocular involvement and compared with that of healthy controls.Materials and methodsOf 51 people studied, 17 had Behçet's disease with ocular involvement, 17 had Behçet's disease without ocular involvement, and 17 were healthy controls. A single eye was examined in each patient. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (Tamax), and resistance index (RI) were evaluated in the ophthalmic (OA), posterior ciliary (PCA), central retinal (CRA) and middle cerebral artery (MCA). Additionally, the average blood flow velocities in the central retinal vein (CRV), and acceleration time (AT) and pulsatility index (PI) in the MCA were calculated.ResultsThe mean EDV in the PCA was 25% lower and RI was higher in patients with ocular involvement of BD than in patients without involvement (p = 0.006 and p = 0.005, respectively) and in healthy controls (p = 0.003 and p = 0.004, respectively). Differences were smaller in comparisons of the CRA and absent on comparisons of the OA and MCA. The acceleration time of the MCA was significantly higher in patients with Behçet's disease than in healthy controls (p = 0.03).ConclusionThis study suggests that the flow hemodynamics in retrobulbar circulation has more altered Behçet's disease with ocular involvement than without ocular involvement and healthy control. Additionally, the cerebral hemodynamic might be affected in patients with Behçet's disease compared with healthy controls.     

Diabetic retinopathy: sonographically measured hemodynamic alterations in ocular, carotid, and vertebral arteries

PURPOSE: To compare local ophthalmic blood flow changes with flow changes in carotid and vertebral arteries in diabetic patients with retinopathy of different grades. MATERIAL AND METHODS: Ten patients with proliferative or preproliferative retinopathy, 10 with mild retinopathy, and 10 matched controls were prospectively studied with ultrasound. Color and duplex Doppler imaging was used to quantitate blood flow in the central retinal arteries (CRA), ophthalmic arteries (OA), common carotid (CCA) and vertebral arteries (VA). Peak systolic velocity (PSV), mean velocity (MV), and resistance index (RI) in CRA, OA, CCA and VA, and volume flow (VF) were measured in CCA and VA. RESULTS: There was a non-significant increase in the CRA and OA velocities in mild retinopathies, a decrease of about 30% in MV, and a slightly increased RI in proliferative or preproliferative retinopathies. There was a decrease of about 15% in the carotid MV and a 20% decrease in the vertebral MV and a decrease of about 30% in VF in the CCA and VA in severe retinopathies. The MV ratio of CRA/CCA was lower in the severe retinopathy group than in the controls. CONCLUSION: The study showed a non-significant increase of ocular blood flow velocities in mild diabetic retinopathy and a significant decrease of flow velocities in severe diabetic retinopathy. This decrease in flow primarily seems to reflect the general decrease of blood flow in the cervical arteries.     

Retrobulbar ocular blood flow and choroidal vascular changes in patients recovering from COVID-19 infection

BackgroundTo evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects.MethodsNinety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU).ResultsThe choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05).ConclusionCOVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.     

Doppler ultrasonography findings in ocular Behçet's disease

The aim of this prospective study was to determine and compare the orbital Doppler ultrasonography parameters of patients with Behçet's disease (with or without ocular involvement) with those of healthy subjects. We evaluated ophthalmic artery (OA), central retinal artery, posterior ciliary artery (PCA), central retinal vein, and superior ophthalmic vein (SOV) flow velocities and resistance indices (RIs). Detection of the decreased flow velocities in the OA and SOV and the increased RI in the OA and PCA might allow the identification of active period of patients with Behçet's disease.