彩色多普勒超声预测肝硬化食管静脉曲张出血高危状态的研究

目的　评价彩色多普勒超声预测肝硬化食管静脉曲张出血高危状态的临床价值。方法　根据有无出血史将肝硬化患者分为出血组 (30例 ) ,未出血组 (62例 )及正常对照组 (30例 )。结果　出血组Dpv、Vpv、Qsv与未出血组及正常对照组比较有显著性差异 (P <0 .0 1 ) ,Dpv、Vpv、Qsv与食管静脉曲张出血的发生率密切相关 (r =0 .943 ,r =- 0 .60 5 ,r=0 .936 ,P <0 .0 1 ) ,可作为预测食管静脉曲张出血高危状态的有效指标 ,经敏感性、特异性验证 ,筛选Dpv≥1 .5cm ,Vpv≤ 1 2cm/s,Qsv≥ 650ml/min作为预测肝硬化食管静脉曲张出血高危状态的危险值。结论　应用彩色多普勒超声检测门脉血流动力学指标 ,可以预测肝硬化食管静脉曲张出血高危状态     

彩色多普勒超声诊断肝硬化的临床价值

目的:对彩色多普勒超声诊断肝硬化的临床价值进行探讨。方法:采集时间段为2018年4月-2019年5月内于我院接受检查的肝硬化患者150例,将其设为观察组;选取同期内接受诊断的150例健康受检者设为对照组,所有受检者均接受彩色多普勒超声检查,对比两组检查结果。结果:经过对比后,发现相较于对照组,观察组门静脉管径、血流流速峰值及平均速度差异显著(P<0.05);大部分肝硬化患者存在脾大、肝脏轮廓锯齿状变化、胆囊壁增厚、肝实质光点增粗、腹腔积液等情况。结论:在肝硬化临床诊断中,可通过彩色多普勒超声进行有效诊断,能够详细显示门静脉管径与肝脏血流动力学变化情况,还能够为临床诊断与治疗提供重要参考依据。     

彩色多普勒超声观测TIPSS术前后门脉血流动力学变化

本文旨在探讨ＴＩＰＳＳ术后门脉血流动力学变化，及彩色多普勒超声对评价疗效的应用价值。采用彩色多普勒超声观察了３２例肝硬化门脉高压症患者门脉血流方向，并测量门静脉、脾静脉和内支架的血流速度。３２例患者３１例手术成功，１例穿刺失败。术前门脉压平均３９±８．２ｃｍＨ２Ｏ，血流速度１６．７±４．７ｃｍ／ｓ；术后门脉压平均２３±５．２ｃｍＨ２Ｏ，平均降低１６±３．７ｃｍＨ２Ｏ，血流速度４８．５±１４．７ｃｍ／ｓ；内支架内血流速度７９．１～１９２ｃｍ／ｓ，平均１２９±４５ｃｍ／ｓ，离肝流向。１４例肝内门脉左、右支血流由术前的进肝流向转为术后离肝流向。其中５例术后１～４月血流又转为进肝流向，经彩超和血管造影检查证实，３例内支架闭塞；另２例狭窄＞７０％。本结果提示，彩色多普勒超声是术后随访、观察分流道开放情况的首远方法。内支架内无彩色血流是分流道闭塞的可靠标志；术后肝内门静脉左、右支“离肝流向”血流是分流道通畅的可靠间接依据。     

脉冲多普勒超声观测肝硬化门脉高压患者脾切除加断流术前后门脉系统血流动力学改变

应用脉冲多普勒超声观测11例肝硬化门脉高压患者脾切除加断流术前后门脉系统血流的最大流速、血流量、血管直径及淤血指数。结果:脾切除加断流术后门脉主干、左支矢状部及右支血流量下降,肠系膜上静脉血流量增加,手术前后的自由门脉压与淤血指数无明显改变;术前自由门脉压与淤血指数呈正相关;术后门脉主干和左支矢状部的血流量减少量与脾静脉的血流量均呈正相关(P<0.01)。本文全面反映了手术前后肝内外门脉各属支的血流动力学变化。     

彩色多普勒超声对慢性乙型肝炎后肝硬化患者胆囊病变的诊断价值

目的:探讨彩色多普勒超声对慢性乙型肝炎后肝硬化患者胆囊病变的诊断价值。方法:将2019年9月—2020年10月期间,在我院接受治疗的慢性乙型肝炎后肝硬化患者作为本研究观察组(n=60);同时选取同期慢性乙型肝炎患者为本研究对照组(n=60),两组研究对象均进行彩色多普勒超声检查。比较两组空腹胆囊厚度与前后径,以及观察组不同类型胆囊壁增厚患者的各项检测情况。结果:观察组空腹胆囊壁厚度与空腹胆囊壁前后径显著高于对照组,且C级患者明显大于A级、B级患者,具有统计学意义(P<0.05)。双边增厚型患者的门静脉内径、血流量,均明显大于单纯增厚型患者,统计学差异显著(P<0.05)。结论:对慢性乙型肝炎后肝硬化患者采用彩色多普勒超声进行检测,能显示出患者的胆囊增厚情况,了解患者门静脉内径与血流速度,有助于临床判断疾病程度,利于为临床治疗疾病提供参考依据。     

彩色多普勒超声对肝硬化门静脉高压症脾动脉栓塞术前后？…

目的：观察肝硬化门静脉高压症患者行脾动脉栓塞前后脾脏及脾静脉血流这变化。方法：栓塞 后对１２例患者采用彩色多普勒超声检查进行观察。结果：脾动脉栓塞后脾静脉、门静脉管径缩小。脾静脉、门静脉平均血流速度降低,血流量明显减少,栓塞前后脾静流速与门静脉主干流速比值及脾静脉与门静脉主干流量幽会比较无明显差异。从而证实在肝硬化门静脉高压形成后,脾静脉血汉量增加是门静脉高压时门静脉血流量增加的重要因素。结论：脾     

二维彩色多普勒超声观测肝硬化门脉高压症脾肺固定合并门奇断流术前后门脉系统血流动力学改变

本文应用二维彩色多普勒超声对8例肝硬化门脉高压症的门脉系统血流动力学在脾肺固定合并门奇断流术前后分别进行定量研究和对比分析。结果表明术后门静脉及睥静脉的内径、平均流速和血流量比术前明显缩小和降低(P<0.001～0.05),门、睥静脉的血流量减少,两者呈正向相关关系(r=0.93,p<0.001)。结果认为该手术能使门静脉系统发生断流、分流和减流.使门静脉系统血流量减少,门脉高压及脾胃区高压缓解。双功能超声对门脉高压症手术方法的选择及效果的评价是一种有临床应用价值的无创性检查方法。     

彩色多普勒超声诊断门脉高压的进展

本文根据五年来２Ｄ—ＣＤＦＩ诊断肝硬化门脉高压的文献，结合长海医院资料从超声相关病理门脉高压的病理检查方法，２Ｄ—ＣＤＦＩ表现，侧支循环的特征，门脉高压肝血流半定量的计算方法及脾肾分流或Ｔｉｐｓｓ术后疗效的估价等方面进行了讨论。认为２Ｄ—ＣＤＦＩ是检测门脉高压的非侵入性、有效实用方法。     

彩色多普勒超声对肝硬化患者眼血流动力学研究

目的应用彩色多普勒超声观察肝硬化患者眼动脉和视网膜中央动脉的血流动力学改变。方法检测35例正常对照组3、0例早期肝硬化患者和31例晚期肝硬化患者眼动脉(OA)和视网膜中央动脉(CRA)的收缩期峰值流速(Vs)、舒张末期流速(Vd)和阻力指数(RI)。结果与正常对照组比较,早期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.05),RI降低(P0.05);晚期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.01),RI升高(P0.05)。结论肝硬化患者眼血管血流动力学改变符合全身高动力循环状态,但随病程进展有不同的表现。     

彩色多普勒超声检测肝硬化患者门静脉系统的临床意义

血吸虫病、肝炎、酗酒等均可导致肝硬化,患者常常合并门静脉高压。彩色多普勒超声检查则是一种非侵入性检查,能够比较准确地反映出门静脉系统的血流变化情况。本次研究通过对50例肝硬化患者检测门静脉系血流动力学指标,了解肝硬化门脉高压症患者门静脉系统血流动力学变化及其临床意义。现报道如下。     

Doppler color flow imaging

By simultaneous processing of frequency, phase, and amplitude information in the backscattered ultrasound signal, new instruments now permit the real-time display of high-resolution grey scale images of tissue combined with the simultaneous display of flow data from vessels within the scan plane. Doppler Color Flow Imaging, or DCFI, using such processing, permits blood flow direction and relative velocity to be detected and displayed in a color encoded display from throughout the ultrasound image. We have tested a new Doppler color flow imaging system over a period of two years to evaluate the carotid arteries, peripheral arteries and veins, and dialysis fistulas. In the abdomen and pelvis we have imaged blood flow to the liver, spleen, kidneys, uterus and renal transplants. Our experience in over 500 patients leads us to conclude that DCFI has significant advantages over conventional duplex Doppler sonography for blood flow evaluation. For examination of carotid and peripheral vessels, we have found DCFI to permit more rapid assessment in both normal and abnormal states. Areas of vessel narrowing or turbulent flow may be identified rapidly and accurately, and vessel orientation may be determined precisely, allowing accurate calculation of blood flow velocity from Doppler frequency shifts. The system we have used has adequate penetration and sensitivity to allow imaging of hepatic and renal blood flow and is extremely promising as a method of imaging organ perfusion and in the detection of abnormalities of perfusion that accompany disease, such as transplant rejection. Tumor vascularity may also be identified with DCFI, opening the possibility of additional clinical applications.     

慢性肝炎彩色多普勒血流成像与肝功能损害程度相关性研究

目的探讨慢性肝炎门静脉血流动力学改变的超声测值与慢性肝功能损害程度的相关性。方法对60例不同程度慢性乙型肝炎患者和60例对照组进行门静脉血流动力学改变的超声测量（门静脉内径、门静脉截面积、门静脉最大流速和门静脉充血指数）,结果与肝功能损害程度相比较：结果慢性肝炎轻度组,门静脉内径较对照组增宽、截面积增大,但差异无显著性意义（P〉0.05）,中度组、重度组门静脉内径增宽、截面积增大明显,与对照组、轻度组比较,差异有显著意义（P〈0.05）．门静脉最大流速在轻度组略减低,与对照组比较差异无显著意义（P〉0.05）,中度组重度组的门静脉最大流速明显减低,与对照组比较差异有显著性意义（P〈0.01）。CI值随着病情进展逐渐增高,差异有显著性意义（P〈0．05）。结论慢性肝炎患者门静脉血流动力学参数能反映肝脏肝功能损害程度,对慢性肝炎的临床治疗评价有一定的价值。     

彩色多普勒血流成像在胰肾联合移植术后的应用价值

目的探讨彩色多普勒血流成像(CDFI)在胰肾联合移植(SPK)术后的应用价值.方法用CDFI定期连续观测10例胰肾联合移植术后患者的声像图特征和动静脉血流变化.结果10例胰肾联合移植术后患者早期均出现移植胰腺体积增大,形态饱满,内部回声减低,胰头及胰尾部增大较胰体部明显,差异存在显著性意义(P＜0.05),多在十数天至1个月后恢复正常;其中2例术后移植肾体积增大,实质增厚,各级动脉血流阻力指数(RI)增高(均在0.71～1.0之间),移植胰腺周围出现局限性积液暗区,供体腹腔干动脉RI波动在0.67～0.78之间,CDFI提示急性排斥反应;1例移植胰腺体积明显增大,内部实质回声不均,胰周积液不断增多,供体腹腔干内动脉RI＜0.70,移植肾声像图正常,CDFI诊断移植胰胰腺炎;另外,CDFI诊断右侧髂外静脉及属支部分栓塞1例;提示移植胰腺供体腹腔干动脉血栓栓塞1例.结论CDFI在胰肾联合移植中具有重要的应用价值.     

经直肠超声彩色多普勒血流成像在药物流产中的应用

目的 探讨经直肠超声彩色多普勒血流成像(CDFI)在药物流产诊断治疗中的应用价值.方法 选择2005年1月-2006年2月在我院妇产科门诊行药物流产的患者65例,应用经直肠超声CDFI观测患者妊娠囊排出后当日其妊娠囊着床部位的彩色多普勒血流状态,并分为3类:Ⅰ类:妊娠囊着床部位无血流信号(16例);Ⅱ类:妊娠囊着床部位见星点状或短棒状血流信号(35例);Ⅲ类:妊娠囊着床部位见火球状血流信号(14例).于药物流产15 d后常规复查宫腔情况.结果 第15天复查发现Ⅰ、Ⅱ类血流显示者宫内未发现残留物;Ⅲ类血流显示者宫腔内均发现残留物并行清宫术,病理检查证实为底蜕膜组织,部分可见绒毛.结论Ⅰ、Ⅱ类血流显示者可动态观察,Ⅲ类血流显示者当日即可行清宫术.经直肠超声CDFI对于预测药物流产是否完全及其临床转归有很高的参考价值.     

Superficial masses with color flow Doppler imaging.

Color Doppler imaging findings and spectral waveforms were reviewed for 21 superficial masses in which color Doppler imaging revealed flow. This series included 5 benign hyperplastic lymph nodes, 5 malignant masses, 2 staphylococcus abscesses, and 9 pseudoaneurysms. Benign hyperplastic nodes had a vascular pattern consisting of prominent central flow with a branching radial pattern, reflecting the morphology of lymph nodes. One metastasis from melanoma demonstrated abundant peripheral flow and central avascularity, while the other 4 malignant masses and the 2 abscesses had sparse internal flow. All pseudoaneurysms had a to-and-fro imaging and spectral pattern (into the mass during systole, out during diastole), and/or a swirling pattern on real-time images (8 of 9 each). Doppler spectral analysis revealed continuous forward flow during diastole for all other masses and abscesses. Waveforms appeared similar for benign and malignant masses, and for abscesses. Conventional image-directed Doppler examinations performed prior to color Doppler studies failed to reveal flow in 2 partially thrombosed pseudoaneurysms, 1 malignant mass, and 1 abscess. Benign hyperplastic nodes, malignant masses, and pseudoaneurysms had distinctive color Doppler image appearances in this series, although demonstration of flow within a mass does not eliminate the possibility of abscess. Proper use of color and spectral Doppler analysis of superficial masses involves more than mere detection or exclusion of flow.     

经阴道彩色多普勒超声对输卵管炎的声像图分析

目的：探讨经阴道彩色多普勒超声（Transvaginal scaning,Color Doppler flow Image,TVS-CDFI)对不同型输卵管炎的声像图及其意义。方法：应用TVS－CDFI技术对28例不同型输卵管炎患的附件区经阴道二维超声图象、血流显像主流速曲线进分析。结果：总结声像图特征可分为三种类型：（1）输卵管团块型：附件区见形态不规则的稍高回声团块，CDFI示内部可见较丰富的彩色血流信号；（2）输卵管积液积脓型：附件区见扭曲扩张的管状回声区，管壁上见彩色血流信号。（3）输卵管囊肿型：附个区见囊状加声，内见皱襞，呈“车轮”状，皱襞处可见彩色血流信号。结论：TV－CDFI是诊断输卵管炎的有价值的检查手段，其扭曲的输卵管和血流特征具有特殊诊断和鉴别诊断意义。     

Diagnosis of acute cholecystitis in patients with liver cirrhosis: waveform analysis of the cystic artery by color Doppler imaging

Purpose The aim of this study was to investigate the possibility of diagnosing acute cholecystitis in patients with liver cirrhosis using color Doppler imaging to demonstrate the hemodynamics.Methods Color Doppler imaging was used to analyze the waveform of the cystic artery in 28 cirrhotic subjects with thickened gallbladder walls and 56 normal controls. The cirrhotic group was further divided into the cholecystitis group, containing 6 cirrhotic patients with acute cholecystitis, and the liver cirrhosis group, containing 22 cirrhotic patients without acute cholecystitis.Results Maximum velocity (Vmax) was significantly higher in the cholecystitis group (31.6 ± 23.0cm/s) than in the normal controls (16.1 ± 5.9cm/s) (P < 0.01). The resistance index (RI) was higher in the liver cirrhosis group (0.84 ± 0.04) than in either the normal controls (0.70 ± 0.06) (P < 0.01) or the cholecystitis group (0.72 ± 0.09) (P < 0.01). Sensitivity and specificity were 100% when the diagnostic criteria of acute cholecystitis were a maximum velocity of more than 40cm/s, a resistance index of more than 0.75, or both.Conclusion A pulsatile signal with a maximum velocity of more than 40cm/s, a resistance index lower than 0.75, or both indicated the presence of acute cholecystitis in patients with liver cirrhosis and a thickened gallbladder wall.     

经阴道彩色多普勒超声在宫腔内残留物鉴别诊断中的应用

目的探讨经阴道超声检查对宫腔内残留物的鉴别诊断价值。方法78例流产后阴道流血超过2周患者,经阴道超声检查发现宫内异常团状回声,观察其二维声像图和团块内、子宫肌壁的彩色血流及多普勒频谱;根据清宫组织病理结果分为绒毛组织、变性的绒毛织组和蜕膜组织,共3组。结果残留绒毛组织为不均匀低回声,变性绒毛组织和脱膜组织为不均匀高回声;残留绒毛组织内部及相邻的子宫肌壁血流信号丰富;变性绒毛组织内部少血流信号,相邻子宫肌壁血流信号丰富;蜕膜组织内部和相邻子宫肌壁少或无血流信号,差异均有统计学意义(P<0.01)。频谱多普勒显示频谱形态以及阻力指数无明显差异(P>0.05),频谱为类滋养血流频谱,阻力指数在0.37~0.45。结论经阴道超声对早孕流产后的宫内残留物可以做出比较明确的诊断,具有鉴别诊断意义。     

桥本氏甲状腺炎的彩色超声声像图分析

目的探讨桥本甲状腺炎(HT)的声像图特征。方法回顾性分析经病理、针吸细胞学及实验室检查确诊的60例HT患者的声像图特征。结果①HT的声像图特征可分为4种类型,即局限型(9例)、结节型(6例)、弥漫型(21例)和弥漫型并结节(24例);②不同声像类型甲功减低的发生率不同;③弥漫型并结节中的HT结节可由弥漫型发展而来,药物干预后结节可逐渐消失而再次转回为弥漫型HT;④弥漫型及弥漫型并结节的HT共45例,其腺体血供均出现不同程度增多,但仅14例呈"火海征"。结论彩色多普勒超声可以对声像图复杂的HT做出比较准确的诊断。