肠系膜上动脉彩色多普勒超声检查方法学研究

目的 建立肠系膜上动脉(SMA)彩色多普勒超声检查方法.方法 选择来我院体检的正常人40名,男女各20名.所有受试者首先对其SMA进行常规彩色多普勒超声检查,然后口服自制混合型小肠声学造影剂后,再次对其SMA进行彩色多普勒超声检查,观察其SMA主干及各级分支的彩色血流图像,测量SMA主干内径、收缩期峰值流速(PS)、阻力指数(RI)和搏动指数(PI).结果 所有受试者行常规彩色多普勒超声检查SMA中上段均可显示,其中9名可显示SMA主干全段,但其分支均未显示.口服自制混合型小肠声学造影剂后,所有受试者行彩色多普勒超声检查均能全面获得SMA主干及各级分支的彩色血流图像,显示率达100%.彩色多普勒显示SMA主干走行较直,至末端呈蝎尾状,各分支走行各异,大部分呈树枝状走行,少数分支可见迂曲回旋,SMA血管网的血流相互交织,呈网络状或菊花状,SMA分支支动脉进入肠壁间呈环状血流.男性正常人SMA主干内径为(0.692±0.059)cm,女性为(0.704±0.094)cm,两者之间的差异无统计学意义(t=-0.437,P＞0.05);男性正常人SMA主干PS为(1.089±0.328)m/s,RI 为(0.835±0.045),PI为(2.495±0.436),与女性的(1.078±0.273)m/s、(0.860±0.421)、(2.889±0.702)比较差异无统计学意义(t=0.323、-0.621、-1.079,P均＞0.05);男性正常人SMA一级分支PS为(0.520±0.226)m/s,RI为(0.772±0.066)、PI为(1.956±0.506),与女性的(0.645±0.156)m/s、(0.833±0.070)、(2.847±0.909)比较差异无统计学意义(t=-2.742、-1.698、-5.217,P均＞0.05);男性正常人SMA二级分支PS为(0.344±0.143)m/s,RI为(0.661±0.045),PI为(1.306±0.268),与女性的(0.392±0.134)m/s、(0.781±0.072)、(2.185±0.754)比较差异无统计学意义(t=-0.981、-2.571、-6.127,P均＞0.05);男性正常人肠壁间动脉PS为(0.196±0.061)m/s,RI为(0.619±0.080),PI为(1.101±0.315),与女性的(0.224±0.100)m/s、(0.716±0.072)、(1.617±0.453)比较差异无统计学意义(t=-1.018、-0.877、-1.399,P均＞0.05).结论 口服自制混合型小肠声学造影剂可对SMA主干及各级分支进行全面的彩色多普勒超声检查.     

连续波DOPPL ER方法测定颈总动脉血流量

应用双声束连续波Doppler方法测定颈总动脉血流速度和5MHz探头B型超声测定颈总动脉血管内径,所计算的颈总动脉血流量,与国外资料相比,基本相似。本文所测得正常人颈总动脉最大血流速度:男性为41.64±10.18cm/s;女性为43.6±10.17cm/s。平均血流速度:男性为13.47±4.05cm/s,女性为14.86±5.14cm/s。平均血流量:男性为4～12ml/s:女性为4～10ml/s。同一例健康人的左、右两侧颈总动脉血流量,将高的一侧与低的一侧相比,两者的比值:男性为1.08±0.08,女性为1.04±0.08。此方法简单,便于临床推广应用。     

超声对胸交感神经节切除术前后肱动脉血流动力学改变的探讨

目的通过彩色多普勒超声对手汗症患者在胸交感神经节切除术前后肱动脉血流动力学的检测,以探讨其在评价胸交感神经节切除效果中的意义。方法应用彩色多普勒超声对33例手汗症患者行胸交感神经节切除术前与术后肱动脉内径(D)、血流量(VOL)、收缩期峰值流速(Vmax)、舒张末期流速(Vmin)、阻力指数(RI)、搏动指数(PI)及收缩期峰值流速/舒张末期流速(Vmax/Vmin)比值等血流动力学指标进行检测与比较。结果术后肱动脉D值为(0.43±0.06)cm,较术前的(0.39±0.06)cm增大,术后VOL为(224.02±79.19)ml/min,较术前的(152.63±58.93)ml/min增多,术后Vmax与Vmin的值分别为(0.79±0.14)m/s、(0.06±0.12)m/s,亦均大于术前的(0.60±0.20)m/s、(-0.04±0.10)m/s;而术后RI、PI与Vmax/Vmin值分别为(0.93±0.14)、(3.74±2.23)、(12.51±9.27),均较术前的(1.08±0.16)、(6.81±3.64)、(22.22±10.13)显著变小,上述各值术后与术前比较P均<0.01。结论彩色多普勒超声观察肱动脉血流动力学变化可作为临床评价胸交感神经节切除效果的一种有效方法。     

老年高血压患者颈动脉血流动力学变化的超声特征

背景血管超声检查动脉管壁的中内膜厚度及粥样斑块与病理学方法相关良好. 目的应用超声方法观察老年高血压患者的颈总动脉和颈内动脉的血流动力学变化,并评价脉压、左室质量指数、血管的阻力指数、切率之间的相互关系. 设计随机对照,相关分析实验. 单位江苏大学附属医院超声科. 对象选择2000-09-30/2002-03-30江苏大学附属医院超声科入选老年高血压患者54例,男33例,女21例.同期在本院超声科检查的正常血压(收缩压＜130 mm Hg和/或舒张压＜85 mm Hg)者为对照组26例,男16例,女10例. 方法彩色多普勒血流显像技术检查每例患者左室腔舒张末内径,室间隔与左室后壁的舒张末厚度,计算左室质量指数.检查双侧颈总动脉和颈内动脉的内径、中内膜厚度和收缩期血流最大峰值流速及阻力指数,计算血管的切率和斑块指数,对动脉压、左室质量指数与阻力指数和切率作线性相关分析,并与同期对照组比较. 主要观察指标①两组受检对象脉压、左室质量指数和颈总动脉斑块指数.②双侧颈总动脉和颈内动脉的内径、中内膜厚度和收缩期血流最大峰值流速及阻力指数,计算斑块指数及最大切率. 结果80例对象均进入结果分析.①老年高血压组脉压,左室质量指数,斑块发生率和斑块指数明显大于对照组[(64.36±7.44)mm Hg,(45.78±8.72)mm Hg;(131.47±18.73)g/m2,(83.28±12.34)g/m2;5.62±1.78,3.44±1.10;66.7%,23.1%,(x213.37,t=5.730-13.234,P＜0.01)].②老年高血压组颈总动脉和颈内动脉的内径、中内膜厚度、阻力指数明显高于对照组[颈总动脉(8.96±1.20)mm,(8.08±0.96)mm;(1.28±0.88)mm,(0.91±0.17)mm;0.75±0.05,0.69±0.06.颈内动脉(6.82±1.12)mm,(5.72±0.92)mm;(1.06±0.17) mm,(0.76±0.15)mm;0.70±0.07,0.64±0.06,t=2.872～10.850,P＜0.01],收缩期血流最大峰值流速和切率明显低于对照组[颈总动脉(47.44±12.85)cm/s,(60.20±14.32)cm/s;(225.78±95.76)/s,(300.26±110.42)/s.颈内动脉(41.22±10.18)cm/s,(48.64±11.58)cm/s;(268.54±112.56)/s,(324.52±121.42)/s,t=2.872～10.850,P＜0.01].③老年高血压患者的脉压,左室质量指数及颈总动脉和颈内动脉的阻力指数、切率之间呈线性弱相关(r=0.30～0.36,P＜0.05). 结论老年高血压患者脉压增大,左室质量指数增加,颈动脉血管扩张,中内膜增厚,阻力指数增大、切率降低,粥样斑块形成,血管壁硬度增加使顺应性下降.     

高原地区和平原地区妊娠子宫动脉、胎儿脐动脉血流变化的对比研究

目的评价高原正常妊娠妇女子宫动脉、胎儿脐动脉血流动力学影响。方法应用彩色多普勒超声诊断仪测定妊娠期和非妊娠期子宫动脉内径、收缩期峰值与舒张末期血流速度(S/D)比值和阻力指数(RI),并与平原地区进行了对比。结果两个地区妊娠期的子宫动脉内径、血流量都有所增加,高原地区妊娠期子宫动脉内径、血流量分别为(0.35±0.04)cm,(280.0±48)cm/s,均低于平原地区(0.45±0.04)cm,(425.4±55)cm/s,P均小于0.01。高原不同孕期脐动脉血流速度S/D比值、阻力指数明显高于平原地区。结论高原对胎盘和胎儿的血流有一定影响,胎盘血流灌注减少,子宫动脉、脐血流速度S/D比值,阻力指数增高。     

乳内动脉的二维及彩色多普勒超声评价

目的评价乳内动脉的超声检查方法和声像图特征。方法应用二维及彩色多普勒显像在前肋间检测双侧乳内动脉,并测量其内径和多普勒血流指标。结果单纯二维超声显像乳内动脉的显示率为77%(57/74),寻找血管平均耗时(79±31)秒;彩色多普勒显像乳内动脉的显示率为100%(74/74),寻找血管平均耗时(31±9)秒。多普勒频谱特征为三相波或两相波。结论经胸高频超声显像是无创性评价乳内动脉的可靠方法。     

多普勒超声心动图在球囊房间隔造口术中的应用价值

目的总结多普勒二维超声指引球囊房间隔造口术(BAS)操作和评价疗效的方法,探讨其临床应用价值.方法采用多普勒超声心动图检查并选择依赖卵圆孔开放维持生命的重症先心病新生儿及婴儿10例.以UM4型多普勒超声心动图仪床边监测并引导Rashkind球囊导管,先后从下腔静脉到右心房,再经卵圆孔入左心房并撕裂房间隔的全过程.最后以多普勒二维超声检查评价造口的大小及效果.结果10例中8例造口成功,房间隔交通口由术前平均3mm增至8mm(4.5～10mm);多普勒测穿房隔血流速度由(1.87±0.2)m/s降至(0.71±0.2)m/s,压力阶差从(12.70±3.0)mmHg降到(2.06±1.46)mmHg,其他临床症状相应改善.结论多普勒超声心动图对术前选择适宜BAS病例,术中指引造口术操作及术后评价造口效果,安全简便,准确可靠,有较高的临床应用价值.     

二维及彩色多普勒血流显像对胃癌的诊断价值

目的 :探讨二维超声及彩色多普勒血流显像对胃癌的诊断价值和声像图特征。方法 :选择经二维超声及彩色多普勒血流显像首诊 ,并与手术病理对照符合、临床确诊的 32例胃癌和正常对照组 30例 ,对其超声检查资料进行分析。结果 :二维超声全部病例均显示胃壁非均匀性增厚 ,平均 15± 4 mm ,明显高于正常对照组胃壁厚度 3.9± 0 .6 mm (P<0 .0 1)。彩色多普勒血流显像胃癌病灶内血流信号检出率 (93.8% ) ,明显高于对照组(6 .7% ,P<0 .0 1) ,胃左动脉显示率 ,胃癌组和对照组分别为 90 .6 %和 93.3% ,两组无明显差异 (P>0 .95 )。脉冲多普勒测定胃左动脉血流参数 ,胃癌组 Vs89.4± 32 .6 mm/s,Vd 2 6 .7± 13.6 mm/s,RI 0 .87± 0 .12 ,对照组 Vs6 7.6± 2 9.4 mm/s,Vd 16 .7± 8.9mm/s,RI 0 .6 1± 0 .17,胃癌组明显高于对照组 (P<0 .0 5 )。结论 :二维超声结合彩色多普勒血流显像有利于提高胃癌诊断准确率 ,具有较高的实用价值     

二维及多普勒超声在锁骨下动脉盗血综合征诊断中的应用

目的分析锁骨下动脉盗血综合征（SSS）的病因、血流动力学、频谱特点、狭窄程度与盗血的关系等问题,评价超声诊断价值。方法患者32例,均经临床检查、超声诊断及相关实验室检查确诊,其中16例经DSA检查证实。仪器应用AcusonSequoia512及128XP/10型超声诊断仪,探头频率2.0～8.0MHz。二维超声常规显示颈动脉、椎动脉、锁骨下动脉及无名动脉的内径及内膜情况,彩色及频谱多普勒检测血流方向及速度。结果32例SSS患者中,动脉硬化及大动脉炎所致各为15例和13例,其他原因者4例。锁骨下动脉狭窄23例,内径0.8～3.8mm,血流速度150～470cm/s;9例锁骨下或无名动脉闭锁,均引起完全性盗血。椎动脉峰值血流速度健侧明显高于患侧（89.0±20.5)cm/svs.(50.6±14.2)cm/s,P＜0.001,患侧出现反向血流。结论SSS最常见病因为动脉硬化和大动脉炎。完全性与部分性盗血与血管狭窄程度有关。彩色多普勒可对完全性SSS做出诊断,部分性者可辅助脉冲多普勒明确诊断。二维及多普勒超声可对绝大多数SSS做出病因学诊断。     

氯沙坦治疗肝硬化门脉高压的临床观察

目的　观察血管紧张素Ⅱ受体拮抗剂氯沙坦 (商品名科素亚 )降低肝硬化门脉高压的作用。方法　 2 5例肝硬化门脉高压患者每天口服氯沙坦 2 5～ 5 0mg,历时 2～ 4周 ,应用多普勒超声分别测定治疗前后门静脉、脾静脉、肠系膜上静脉内径 ,并计算门静脉、脾静脉的血流量。结果　治疗后门静脉内径明显缩小 ,从 (14 11± 2 11)mm降到 (12 11± 1 87)mm(P <0 0 1) ,血流量从 (1185 5 2± 812 6 0 )mL/min降到 (6 4 1 91± 390 30 )mL/min(P <0 0 1) ;脾静脉、肠系膜上静脉内径及其血流量也有所降低 ,无显著性意义。结论　氯沙坦具有一定程度的降门脉压力作用。     

Doppler sonography of the inferior mesenteric artery: a preliminary study.

The purposes of this study were to look for the inferior mesenteric artery in patients undergoing abdominal sonography, to determine in what percentage of patients it is visible, and to characterize Doppler flow patterns of the inferior mesenteric artery in fasting patients without intestinal vascular disease. The inferior mesenteric artery was sought in 100 consecutive fasting adults (mean age, 54 years; 63 women, 37 men), as follows: the infrarenal aorta was scanned in a transverse plane; the origin of the inferior mesenteric artery was identified on the left anterolateral surface of the aorta; the inferior mesenteric artery was then traced caudally along the left side of the aorta. The inferior mesenteric artery and the superior mesenteric artery were studied with Doppler sonography in 50 different subjects without clinical or Doppler sonographic evidence of abdominal vascular disease (mean age, 44.9 years; 17 men, 33 women). Pulsed Doppler samples were taken within the inferior mesenteric artery in sagittal planes. The resistive index was calculated from the superior mesenteric artery and the inferior mesenteric artery. The inferior mesenteric artery was detected in all but eight patients (92%). In seven patients obesity prevented visualization. The eighth patient had undergone abdominal surgery on the previous day, limiting the sonographic examination. The diastolic flow in the inferior mesenteric artery was less than that in the superior mesenteric artery in all patients. The resistive index was 0.959 +/- 0.045 in the inferior mesenteric artery and 0.856 +/- 0.046 in the superior mesenteric artery (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Duodenal meal stimulation leads to coeliac artery vasoconstriction and superior mesenteric artery vasodilatation: an intra-abdominal ultrasound study

To evaluate the influence of duodenal feeding on splanchnic blood flow, 14 patients with normal coeliac and superior mesenteric arteries underwent intra-abdominal duplex scanning of the systemic and splanchnic circulation under standardised basal and meal-stimulated conditions. Doppler samples and diameter measurements were taken of the aorta, coeliac artery, common hepatic artery, splenic artery, superior mesenteric artery, and inferior mesenteric artery. Duodenal meal stimulation has no systemic effects (p > 0.4). However, duodenal meal stimulation results in coeliac artery vasoconstriction (p < 0.06) and superior mesenteric artery vasodilatation (p < 0.05). This study supports other reported results that gastrointestinal blood flow is dependent on the site of food stimulation.     

肠系膜下血管的腔镜下解剖学观察

目的:阐明肠系膜下动脉(inferior mesenteric artery,IMA)和肠系膜下静脉(inferior mesenteric vein,IMV)的腔镜下解剖学特点,以指导腔镜下血管定位.方法:解剖和观察15具尸体;对126例接受腹腔镜左侧结肠癌和直肠癌手术的患者进行术中观察和术后录像复习.结果:IMA起自腹主动脉前壁,起点大部分平L3椎体或L3-4椎间盘,与主动脉分叉距离(42.08±6.26)mm;IMA分支有多种变异.腔镜下:系膜前,IMA表现为自主动脉前面向左下走行、乙状结肠系膜内隆起并搏动的条索;系膜后,IMA主干位于结肠系膜偏后部,IMA根部是左结肠后间隙内的固有障碍.在左髂总动脉水平,IMA位于左输尿管、左性腺血管内侧,三者位置关系恒定.IMA根部神经纤维分布少.IMV走行于IMA左侧的结肠系膜内,末段与动脉分离后,经十二指肠空肠襞左缘后方进入胰体后面.结论:正确的外科间隙(左结肠后间隙)、标志、外观和线索,是腹腔镜下IMA和IMV定位的解剖学基础.     

超声在胡桃夹综合征3D打印血管外支架治疗评价中的临床价值

目的:探讨超声在胡桃夹综合征(NCS)3D打印血管外支架植入术疗效评价中的临床价值。方法:纳入2015年12月至2018年12月在空军军医大学第二附属医院拟行腹腔镜3D打印血管外支架植入术治疗的NCS患者41例。所有患者于术前及术后1周分别行超声及CT血管造影(CTA)检查,评估左肾静脉受压情况及相关血流动力学改变。结果:术前超声显示腹主动脉与肠系膜上动脉之间的夹角为(21.29±4.53)°,术后为(47.42±7.45)°,较术前显著改善(P<0.001)。术前可见左肾静脉明显受压,最细处内径仅为(1.51±0.49)mm,且血流峰值速度为(143.92±50.40)cm/s;术后超声检查显示左肾静脉受压狭窄处明显扩张,未见高速血流;术后肾门处左肾静脉内径、肾门处左肾静脉血流速度、精索静脉内径较术前均显著改善(P<0.001)。与超声检查结果类似,CTA亦发现术后腹主动脉与肠系膜上动脉之间的夹角较术前显著增大[(17.59±4.56)°对(52.27±9.01)°,P<0.001],术前CTA测得左肾静脉受压处内径为(2.09±0.86)mm,术后明显扩张,肾门处左肾静脉内径治疗后显著减小(P<0.001)。结论:超声检查能够有效评估NCS患者3D打印血管外支架植入术治疗前后的左肾静脉受压情况及相关血流动力学改变,可为该类患者的临床疗效评价提供一种可靠方法。     

冠心病患者心肌内血流状态和盗血现象的多普勒显像研究

目的应用冠脉血流显像技术评价冠心病患者的心肌内血流特征,探讨该技术在检测心肌内血流方面的价值。方法应用冠脉血流显像技术检测15例正常人和14例冠脉造影证实为前降支中段和近段狭窄的冠心病患者前壁心肌内血流,显示清晰二维彩色多普勒信号后,应用脉冲多普勒探测血流频谱;分别在不同时刻经静脉注射Albunex0.08ml/kg和潘生丁0.56mg/kg后,观察前壁心肌内彩色多普勒血流信号和频谱变化。结果15例正常人和13例前降支狭窄患者前壁心肌内能显示出冠脉血流信号,频谱显示以舒张期灌注为主,收缩期存在少量逆流;这些人中注射Ablunex后心肌内血流信号明显增强,但血流速度增加不明显〔(0.33±0.06)m/s,P＞0.05〕;注射潘生丁后14例正常人和10例冠心病患者心肌内血流信号明显增强,血流速度亦明显增加〔(0.33±0.10)m/s和(1.08±0.07)m/s;(0.30±0.12)m/s和(0.61±0.12)m/s和(0.61±0.12)m/s,P＜0.05〕,于5～8分钟达峰值,冠心病组心肌内峰值血流速度与基础血流速度之比明显低于正常人组(2.02±0.44和2.87±0.45,P＜0.05);同时心外膜血流速度亦明显增快,冠脉速度储备在正常对照组高于冠心病组(分别为3.54±0.33和2.40±0.29,P＜0.05)注射潘生丁后5～9分钟时3例冠心病患者心肌血流难以显示,前降支血流速度减慢,同时伴有胸痛、胸闷,2例心电图提示ST段压低加重,1例出现“T”波假性正常化,提示“盗血”现象存在。结论CDCFI能敏感准确显示心肌内血流信号,发现其与心外膜血流的不同特征;为评价心肌血流灌注和分析心肌血流动力学提供新的直接依据;可能为临床提供直接评价心肌内局部血流储备的新方法;能直接发现“盗血”现象时冠脉血流的改变。     

彩色多普勒超声在左肾静脉压迫综合征诊断中的应用

目的探讨彩色多普勒超声对左肾静脉压迫综合征的可靠性和实用性。方法利用彩色多普勒超声对22例左肾静脉压迫综合征患者及19例正常者进行对照检查,分别检查腹主动脉(AO)与肠系膜上动脉(SMA)之间左肾静脉受压处前后径(b)、受压处前方左肾静脉最宽处内径(a),受压处左肾静脉内峰值血流速度(Vp)、峰值血流加速时间(AT)。结果全部受检者均可见AO与SMA之间的LRV不同程度受压,但两组间b、a/b、Vp及AT有显著性差异(P<0.01)。结论彩色多普勒超声是诊断左肾静脉压迫综合征快速、可靠和有效的方法。     

Varicocele and the testicular-renal venous route: hemodynamic Doppler sonographic investigation.

The aim of this study was to quantify the anatomic and hemodynamic components of the testicular venous drainage for the purpose of understanding their mechanisms of interacting in producing mutual effects, such as "nutcracker" phenomenon, reflux, and varicoceles. Seventy-five male subjects were studied at rest and during Valsalva maneuver. Aortomesenteric distance and angle, flow velocity in different segments of the renal veins, testicular vein diameter, and flow inversion were evaluated using standard ultrasound equipment with spectral and color Doppler capabilities. The velocity of flow in the proximal segment of the left renal vein (17.5 cm/s) was found to be significantly lower than that in both the distal left renal vein (121 cm/s) and the right renal vein (37 cm/s). The flow velocity in the proximal left renal vein decreased with decrease in the aortomesenteric distance and angle. Testicular vein diameters greater than 3 mm were statistically associated with decreased superior mesenteric artery angle. A significant association also was found between the left testicular vein diameter (in Valsalva maneuver) and inversion of flow. The decrease in flow velocity in the left renal vein proximal to the bifurcation of the superior mesenteric artery from the aorta supports the "nutcracker" theory. An association was found between the decrease of superior mesenteric artery angle and the increase in testicular vein diameter. Another association exists between the presence of reflux during Valsalva maneuver and increased testicular vein diameter. These finding were significant only for testicular vein diameter values greater than 3 mm.     

冠状动脉慢血流现象的冠状动脉血流成像分析

目的 应用冠状动脉血流成像(CFI)无创性评估冠状动脉慢血流现象患者的冠状动脉血流速度变化.方法 冠状动脉无明显狭窄且心肌梗死溶栓试验(TIMI)提示慢血流现象患者21例,冠状动脉造影无明显狭窄且TIMI血流正常者9例作为对照组.采用校正的TIMI血流计帧法(CTFC)评价冠状动脉血流速度.常规超声心动图测量左室舒张末期内径、收缩末期内径、左室射血分数、E峰、A峰、E/A值.CFI测量冠状动脉前降支远端舒张期峰值血流速度(Vmax)、舒张期平均流速(Vmean)和血流速度时间积分(VTI).结果 慢血流组前降支CTFC为(45.37±8.62)帧,对照组为(15.94±4.66)帧,二者差异有统计学意义(t=-9.596,P=0.000).慢血流组与对照组常规超声心动图测值差异均无统计学意义.慢血流组前降支Vmax为(22.86±3.04)cm/s,Vmean为(17.62±2.89)cm/s,VTI为(8.49±2.01)cm;对照组前降支Vmax为(31.78±9.28)cm/s,Vmean为(23.67±7.60)cm/s,VTI为(10.91±4.47)cm,两组差异均有统计学意义(P＜0.05).对照组及慢血流组前降支CTFC与Vmax和Vmean呈负相关,对照组前降支CTFC与VTI呈负相关,慢血流组前降支CTFC与VTI无相关性.结论 冠状动脉慢血流现象患者冠状动脉前降支远端血流速度减慢,CFI能够反映冠状动脉造影TIMI血流的变化,但诊断冠状动脉慢血流现象有局限.

Abstract：

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).Methods Twenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.     

后胡桃夹综合征患者彩色多普勒超声表现

目的 分析后胡桃夹综合征患者彩色多普勒超声表现,探讨彩色多普勒超声检查对后胡桃夹综合征的诊断价值.方法 回顾性分析8例经临床和相关检查确诊的后胡桃夹综合征患者的超声声像图.应用彩色多普勒超声检查观察左肾静脉的形态、走行,测量腹主动脉后方狭窄处和腹主动脉左侧扩张处左肾静脉的前后径、血流速度,计算狭窄处与扩张处的内径和血流速度比值.结果 彩色多普勒超声可清晰显示左肾静脉自肾门处注入下腔静脉的全程.本组8例胡桃夹综合征患者经多角度、多切面扫查均见左肾静脉穿越腹主动脉后方与腰椎之间隙汇入下腔静脉,狭窄处左肾静脉内径为(1.5±0.4)mm,血流速度为(154.5±30.1)cm/s;扩张处左肾静脉内径为(8.7±1.4)mm,血流速度为(22.8±3.4)cm/s;左肾静脉内径、血流速度比值分别为1:(6.5±0.5)及1:(7.2±0.9).结论 彩色多普勒超声检查可准确评价左肾静脉走行变异导致的左肾静脉扩张及血流动力学变化,对临床诊断、治疗后胡桃夹综合征具有重要的应用价值.     

肠系膜上动脉压迫综合征彩色超声的诊断价值

目的：探讨肠系膜上动脉压迫综合征彩色超声的诊断价值。方法：应用彩色多普勒超声诊断的36例肠系膜上动脉压迫综合征,均经放射线胃肠钡餐透视检查证实。结果：本组超声显像诊断的符合率为100%,肠系膜上动脉（SMA）与腹主动脉（AA）之间夹角及十二指肠通过段距离变小,饮水后其近端十二指扩张明显,左侧卧位时十二指肠潴留消失。结论：CDFI对该病的诊断准确性高无损伤、实时,能同时显示肠管形态,判断血管的位置。