艾滋病合并肺结核的多元化影像学表现

目的：探讨艾滋病合并肺结核的多元化影像学表现。方法：回顾性分析45例艾滋病（acquired immunodetieieney syndrome,AIDS）合并肺结核的影像学资料,CT扫描31例,DR胸片14例,经CT引导下穿刺26例,综合分析艾滋病合并肺结核的影像学表现特征。结果：45例艾滋病合并肺结核患者,病灶累及1个肺段的10例,2个肺段的6例,3—5个肺段的4例,两肺弥漫性分布的20例,肺部无阳性表现者5例,其中病理证实同时合并卡氏肺孢子虫肺炎（pneomoeystis carinii pneumonia,PCP）10例,合并细菌（化脓菌）感染8例,合并真菌感染5例。结论：艾滋病合并肺结核的影像学表现多种多样,同时合并多种病原体感染,病变表现形态多样,影像学表现缺乏特异性,肺部穿刺活检病理证实仍不失为金标准。     

肝癌合并动静脉瘘的介入诊断及治疗

目的 分析肝细胞癌(HCC)合并肝动脉一静脉瘘(HAVS)的诊断及介入处理方法，探讨临床疗效。方法 收治的453例肝细胞癌，33例合并HAVS。根据造影诊断分别进行明胶海绵或弹簧圈堵塞瘘口，合并或单独使用丝裂霉素、卡铂粉、碘油混合乳剂进行瘤体栓塞。此外，对于冈HAVS所致的严重门脉高压反复上消化道出血3例患者，实施了经皮肝穿刺胃冠状静脉栓塞术。结果 肝动脉-门静脉瘘(HAPS)24例，HAVS7例，混合型2例：HAVS经处理瘘口达到完全栓塞后行肝动脉化疗栓塞(TACE)时，26例丝裂霉素、卡铂、碘油乳剂均能较好地沉积在瘤体内其余7例瘤体内栓塞剂沉积不好其中3例反复上消化道出血的患者经皮肝穿刺胃冠状静脉栓塞术后1d出血停止。结论 对于肝细胞癌合并HAVS患者，数字减影血管造影(DSA)是必要的检查手段，栓塞治疗是有效的治疗方法。     

邦消安治疗胆汁返流性胃炎临床观察

目的　探讨邦消安治疗胆汁返流性胃炎的疗效与作用机制。方法　胆汁返流性胃炎患者同时用邦消安和铝碳酸镁咀嚼片 (胃达喜 ) ,比较治疗前后胃液一氧化氮和甘胆酸水平。结果　两组治疗 ,病人的症状均可明显好转 ,邦消安治疗后胃液一氧化氮和甘胆酸水平均明显下降 ,胃达喜治疗后胃液甘胆酸水平明显下降。结论　邦消安对胆汁返流性胃炎有较好的疗效 ,其作用可能与促进胃排空 ,防止返流有关     

不稳性寰椎骨折的外科治疗策略

目的 探讨枕颈或寰枢椎内固定融合技术治疗不稳性寰椎骨折的临床疗效和应用价值.方法 对2004年10月-2009年3月收治的不稳性寰椎骨折38例进行回顾性分析,其中6例寰椎爆裂性骨折合并寰枕关节不稳(5例行C0～C2固定融合术,其中1例同时合并有C7椎体压缩性骨折行C0～C3固定融合术),7例典型的Jefferson骨折,3例半环骨折,8例寰椎骨折合并Ⅱ型齿状突骨折,3例寰椎骨折合并Hangman骨折(其中2例Levine-Edwards Ⅲ型行C0～C3固定融合术,1例Ⅱ型行C1～C2固定融合术),3例寰椎骨折合并下颈椎损伤,6例寰椎横韧带断裂(Dickman Ⅰ型)伴寰枢关节不稳,2例寰椎粉碎性骨折合并寰椎侧块内侧骨性结构附着处横韧带撕裂(DickmanⅡ型).5例行C0～C2固定融合术,3例行C0～C3固定融合术,30例行C1～C2固定术并行自体髂骨植骨融合.结果 所有患者术后均获得随访,平均随访时间为28个月(12～46个月).临床症状均得到不同程度的改善.平均手术时间135 min(80～190 min),平均失血量460ml(200～3 300 ml),平均透视时间60 s.38例患者术中均未发生神经、椎动脉和其他手术相关并发症.全部患者均于术后3 d颈托固定后下地行走;术后脊髓损伤症状无加重.3例因电刀灼伤C1～C2间血管静脉丛导致出血,行止血纱布、脑棉片填塞止血,未出现颅脑缺血症状.复查X线片和CT未发现上颈椎失稳或复位丢失,螺钉位置良好,无松动、断钉,寰枢椎或枕颈部均获骨性融合.在晚期随访中,4例(11%)有颈部疼痛和僵硬感,1例枕神经痛.结论 对具有不稳定性寰椎骨折或合并寰椎横韧带损伤的患者,采用枕颈或寰枢椎内固定融合技术及短期外固定对于重建上颈椎永久稳定性是较好的手术方式,并且能阻止神经和脊髓功能的进一步损伤.

Abstract：

Objective To evaluate the clinical effect and safety of the occiput-cervicle or C1-C2 internal fixation and bone graft fusion in treatment of the unstable atlas fracture.Methods A retrospective study was performed in 38 patients with unstable atlas fractures treated by the occiput-cervicle or C1-C2 internal fixation and bone graft fusion from October 2004 to March 2009.Six patients with comminuted atlas fracture combined with instability of the occipito-atlantoid articulations were treated with occiput-C2 fusion(five patients)and with occiput-C3 fusion(one patient).There were seven patients with typical Jefferson fractures,three with semiring fractures,eight with atlas fractures combined with Anderson type Ⅱ odontoid process fractures,three with atlas fractures combined with Hangman's fractures (two patients with Levine and Edwards type Ⅲ Hangman's fractures were treated with occiput-C3 fusion and one patient Levine and Edwards type Ⅱ Hangman's fracture was treated with C1-C2 fusion),three with atlas fracture combined with lower cervicle injury,six with rupture of transverse ligament combined with instability of atlanto-axial joint(Dickman transverse ligament type Ⅰ injury)and two with comminuted fracture of the lateral mass associated with bony avulsion of the medial tubercle and transverse ligament(Dickman transverse ligament type Ⅱ injury).Of all,five patients were treated with occiput-C2 fusion,three treated with occiput-C3 fusion and 30 treated with C1-C2 fusion.Results All the patients were followed up for a range of 12-46 months(average 28 months),which showed improvement of clinical symptoms in some extent postoperatively.The operation time ranged from 80 to 190 min ates(average 135 minates),with intraoperative blood loss for 200-3 300 ml(average 460 ml)and average fluoroscopic time for 60 seconds.There were no neurological deficits,vertebral artery related complications or other complications in all the patients during the surgical operation.No neurological deficit was aggravated after the patient's mobilization with brace three days after operation.The enous plexus of blood vessel at C1-C2 rupture induced by the use of electrocautery was found in three patients who showed no cerebral hemodynamic deficit after hemostasis with hemostatic sponge and cotton piece.The follow-up X-ray and CT manifested osseous fusion in all the patients,with no looseness or breakage of the screws.The late follow-up showed pain associated with movement and limited range of motion in four patients(11%)and occipital neuralgia in one.Conclusions An occiput-cervicle fixation fusion or a C1-C2 fixation fusion combined with short external fixation can reestablish the upper cervical stability and prevent further injury of the spinal cord and nerve function and hence is an ideal option for C1 burst fracture with or without rupture of the transverse ligament.     

Spin-echo anatomy of the larynx with magnetic resonance at 1.5 T

The larynges of 8 healthy and informed volunteers were studied with a superconductive MR unit at 1.5 T together with those of 10 patients with extralaryngeal pathologic conditions. The study was performed with round surface coils (5") and with dedicated sellar coils in the anterior neck. Slices were 5 mm thick, and acquired on the coronal, axial, and sagittal planes, with T1-weighting; axial scans were repeated in the same locations with double echoes, with proton-density and T2-weighting. Five patients underwent additional scans after Gd-DTPA. The larynx of a semi-frozen cadaver was examined with sellar surface coils, on similar scanning planes and with similar pulse sequences to those described above; the larynx was removed, investigated with mammographic technique, and subsequently analyzed with thin CT slices and a high-resolution reconstruction algorithm for the study of laryngeal cartilage. Axial anatomical sections were then compared with MR and CT scans, and the anatomical structures were recognized on the triplanar MR scans of a volunteer's larynx. Besides MR anatomy of supporting laryngeal structures, the authors describe in detail the muscles, plicae, spaces and cavities which can be identified on the various planes, together with the changes in signal after Gd-DTPA.     

耳垂缺损的不同方法修复效果观察

目的探讨用不同方法行耳垂缺损再造修复的可行性及优缺点。方法1995年1月-2006年7月共收治耳垂缺损患者45例,根据耳垂缺损的大小及对侧耳垂情况分别采用不同的手术方式进行修复再造。对于18例缺损面积较小的耳垂缺损采用耳轮滑行推进皮瓣法修复,15例中等程度缺损患者采用耳后皮瓣法修复,12例完全缺损,或虽不是完全缺损但健侧耳垂较大的患者采用皮肤扩张术 自体肋软骨移植法修复。结果45例患者分别采用上述方法进行再造修复后,耳廓、耳垂形态良好,随访4个月-8年,效果满意。结论对于不同程度的耳垂缺损畸形,应根据具体情况采用相应的修复方法,以达到最佳治疗效果。对于耳垂完全缺损或虽不是完全缺损但对侧耳垂较大的患者,应首选皮肤扩张术 自体肋软骨移植法,以获得形态良好而持久的再造耳垂。     

Root of the superior mesenteric artery in pancreatitis and pancreatic carcinoma: evaluation with CT

To determine if changes involving the root of the superior mesenteric artery are specific for neoplasm, the authors retrospectively reviewed 173 computed tomographic (CT) examinations of patients with proved pancreatitis (103 examinations) and pancreatic ductal adenocarcinoma (70 examinations). Streaky infiltration of the fat surrounding the root was seen in 27 of 56 examinations of acute pancreatitis, in four of 24 examinations of chronic pancreatitis, in 12 of 23 examinations of pancreatitis complicated by abscess, and in 25 of 70 examinations of pancreatic carcinoma. Periarterial lymph nodes were visible in 14 with acute pancreatitis, in three with chronic pancreatitis, in six with pancreatic abscess, and in 11 with pancreatic carcinoma. A focal mass extended to within 1 cm of the root in 10 with acute pancreatitis, in two with chronic pancreatitis, in four with pancreatic abscess, and in 24 with pancreatic carcinoma; the mass obliterated the periarterial fat in seven with acute pancreatitis, in one with pancreatic abscess, and in 18 with pancreatic carcinoma. Circumferential encasement occurred in one with chronic pancreatitis, in four with pancreatic abscess, in 14 with pancreatic carcinoma, and in none with acute pancreatitis; nearly all cases of encasement revealed loss of periarterial fat. Thus, these indicators are not specific for neoplasm.     

多层螺旋CT曲面重建在先天性外耳道闭锁中面神经管异常的研究

目的用多层螺旋CT(MSCT)曲面重建(CPR)技术研究先天性外耳道闭锁中面神经管的异常。方法对15例(17耳)先天性外耳道闭锁患者进行多层螺旋高分辨率CT(HRCT)扫描,图像后处理在Philips Mx8000工作站进行。结果17耳中,外耳道狭窄2耳,外耳道膜性闭锁2耳,骨性闭锁13耳。外耳道先天性胆脂瘤及耳后瘘管1耳。鼓室畸形3耳。听小骨先天畸形7耳。内耳畸形1耳。面神经管异常17耳。其中面神经管总长度变短11耳,面神经管走行异常5耳,面神经管位置异常9耳,面神经管管径变细1耳,面神经管分叉1耳。结论MSCT高分辨率扫描加CPR技术能清晰显示先天性外耳道闭锁患者中面神经管的异常,有利于临床医生术前详尽了解面神经管的行程,减少不必要的面神经意外损伤。     

肿瘤相关性皮肌炎的~(18)F-FDG PET-CT影像特点

目的：探讨肿瘤相关性皮肌炎的18F-FDGPET-CT影像特点。方法：回顾性分析9例皮肌炎合并恶性肿瘤患者的临床资料和18F-FDGPET—CT显像资料,采用Mann-WhitneyU秩和检验对恶性肿瘤病灶与骨骼肌的SUVmax的相关性进行统计学分析。9例中胆囊癌3例,肺癌2例,卵巢癌、食管癌、结肠癌及恶性淋巴瘤各1例。结果：所有恶性肿瘤病灶的18F-FDG摄取较高,SUVmax为7．26±5．48;7例患者18F-FDGPET—CT显像示全身骨骼肌弥漫性对称性轻度摄取增高,SUVmax为3．45±0．81,与恶性肿瘤问差异有统计学意义（Z=-2．910,P=0．004）。同机cT扫描还发现1例合并间质性肺炎,3例合并肺部感染。结论：肿瘤相关性皮肌炎的18F-FDGPET-CT表现有一定特征性,认识其影像学表现,有助于提高对此病的诊断准确性。     

Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model

PURPOSE: To determine whether transcatheter arterial embolization (TAE) with iodized oil and gelatin sponge particles can be used to expand radiofrequency (RF)-induced coagulation necrosis, the morphology and histologic characteristics of ablation lesions were evaluated in the normal pig liver after three different TAE procedures. MATERIALS AND METHODS: Ten consecutive animals with 33 ablation lesions produced with an RF ablation system were randomly assigned to one of three treatment groups and a control group: a group treated with TAE with iodized oil, a group treated with TAE with gelatin sponge, a group treated with TAE with iodized oil and gelatin sponge, and a control group in which TAE was not performed. After the completion of ablation, the lesions were excised for gross and histologic examination. RESULTS: The longest and shortest diameters of ablation lesions were greatest in the group treated with TAE with iodized oil and gelatin sponge, followed by the groups treated with TAE with gelatin sponge and TAE with iodized oil (P < .05 vs controls, respectively). The hemorrhagic rim was also widest in the group treated with TAE with iodized oil and gelatin sponge (P < .05 vs controls), and it spread toward the liver periphery like a segmental hemorrhagic area adjacent to the ablation lesion. Histochemical staining for lactate dehydrogenase, maleate dehydrogenase, and nicotinamide adenine dinucleotide diaphorase showed what appeared to be 100% cellular destruction in all the ablation lesions and their hemorrhagic rims. CONCLUSION: RF ablation combined with TAE with iodized oil and gelatin sponge induces the greatest area of coagulation necrosis accompanied by peripherally spreading segmental necrosis in normal pig liver tissue.     

Muscle strength and kinetic gait pattern in children with bilateral spastic CP

Cerebral palsy is often associated with an abnormal gait pattern. This study put focus on relation between muscle strength and kinetic gait pattern in children with bilateral spastic cerebral palsy and compares them with a reference group. In total 20 children with CP and 20 typically developing children participated. They were all assessed with measurement of muscle strength in eight muscle groups in the legs and a 3-dimensional gait analysis including force data. It was found that children with CP were not only significantly weaker in all muscle groups but also walked with slower velocity and shorter stride length when compared with the reference group. Gait moments differed at the ankle level with significantly lower moments in children with CP. Gait moments were closer to the maximal muscle strength in the group of children with CP. Furthermore a correlation between plantarflexing gait moment and muscle strength was observed in six of the eight muscle groups in children with CP, a relation not found in the reference group. A similar pattern was seen between muscle strength and generating ankle power with a rho=0.582-0.766. The results of this study state the importance of the relationship of the overall muscle strength pattern in the lower extremity, not only the plantarflexors.     

脑性瘫痪的MRI特征

目的:探讨脑性瘫痪(脑瘫)患儿的头颅MRI表现及其与脑瘫类型的关系。方法:回顾性分析81例脑瘫患儿的临床资料与MRI表现。结果:81例脑瘫患儿MRI异常率为85.2%,痉挛型双瘫、四肢瘫、偏瘫、不随意运动型脑瘫、共济失调型脑瘫、肌张力低下型脑瘫和混合型脑瘫MRI异常率分别为92.9%、100%、100%、60%、87.5%、50%和81.8%。各类型脑瘫的MRI异常表现不同,痉挛型双瘫以脑室周围白质软化(PRL)为主,偏瘫型突出表现为单侧脑损伤,四肢瘫表现为广泛、弥漫、双侧脑损伤,不随意运动型表现为基底节病变或PVL,共济失调型绝大部分存在先天性小脑发育不全。结论:MRI有助于评价各型脑瘫的病理特点,对脑瘫病因的推测有帮助。     

冠心病患者血清葡萄糖和果糖胺测定的临床应用

目的探讨冠心病患者高血糖和果糖胺之间的关系。方法测定35例冠心病合并糖尿病患者和38例无糖尿病的冠心病患者的血清葡萄糖和果糖胺浓度。结果冠心病合并糖尿病组及无糖尿病的冠心病组的血糖水平分别为（9.58±1.30）mmol/L、（5.16±0.60）mmol/L,都明显高于正常对照组（4.78±0.55）mmol/L,P〈0.05。冠心病合并糖尿病组果糖胺（280±62）μmol/L,显著高于正常对照组果糖胺（180±35）μmol/L,P〈0.05,糖尿病组与无糖尿病组患者的果糖胺水平比较有显著差异（P〈0.05）,但无糖尿病冠心病组果糖胺水平（180±68）μmol/L与正常对照组比较却无显著差异（P〉0.05）。结论联合检测血糖与果糖胺对冠心病患者血糖增高的原因有鉴别价值。     

Delayed lung scintigraphy with N-isopropyl-I-123-p-iodoamphetamine in lung cancer and inflammatory disease

Lung studies with N-Isopropyl-I-123-p-Iodoamphetamine (IMP) were performed on patients with lung cancer or inflammatory disease. In the present study, we evaluated the usefulness of the delayed scintigraphy. The subjects consisted of 27 patients with lung cancer (34 lesions), 3 with radiation pneumonitis, 2 with interstitial pneumonitis, 2 with old tuberculous lesion (tuberculomas), 1 with diffuse panbronchiolitis, 1 with pneumonia and 1 with lung abscess. The delayed scintigraphy was performed 24 hr after intravenous injection of 3 mCi IMP, in sitting position. In 10 patients, SPECT images were obtained following the delayed scintigraphy. Delayed scintigraphic appearances of lung cancer were classified into 5 types, high IMP uptake in the area congruent with the lesion of atelectasis and/or obstructive pneumonia (Type I), high IMP uptake in the area surrounded the tumor (Type II), a defect in the area consistent with the tumor and no high IMP uptake in the area surrounded the tumor (Type III), high IMP uptake in the area almost congruent with the tumor (Type IV) and no significant change (Type V). Excluding 10 lesions with Type IV or V, no IMP uptake was seen in the areas congruent with the tumors. Type II was the most frequently observed pattern. Normal scintigrams (Type V) were observed in 8 lesions, whose sizes were fairly small. There was no definite trend caused by difference in histological types of cancers. In 8 patients with viable inflammatory disease of the lung, the delayed scintigrams showed high IMP uptake in the areas congruent with the abnormalities on chest roentgenograms.(ABSTRACT TRUNCATED AT 250 WORDS)     

乌司他汀联合生长抑素治疗重症急性胰腺炎疗效观察

 目的 观察联合应用乌司他汀和生长抑素治疗重症急性胰腺炎的疗效.方法 重症急性胰腺炎38例,分为生长抑素治疗组18例,乌司他汀+生长抑素治疗组(联合治疗组)20例,观察不同方案治疗组患者的症状、体征、血淀粉酶、C反应蛋白、TNF-a、IL-6、IL-8的变化.结果 (1)联合治疗组的症状、体征缓解率明显高于生长抑素组(P＜0.05);(2)联合治疗组的血淀粉酶及白细胞水平和生长抑素组相比下降速度更快(P＜0.05);(3)治疗后两组的CRP、TNF-a、IL-6、IL-8均下降,但治疗后第3天、第5天,联合治疗组较生长抑素治疗组CRP、TNF-a、IL-6、IL-8值更低、下降速度更快(P＜0.05);(4)联合治疗组的有效率(90.O%)明显高于生长抑素治疗组(72.2%)(P＜0.05).结论 联合应用乌司他汀和生长抑素治疗重症急性胰腺炎,可控制病情发展,提高治疗有效率,值得临床进一步观察.     

艾滋病25例临床分析

目的总结艾滋病的临床特征,以提高对其感染的认识。方法25例艾滋病及其并发症的临床表现和实验室资料进行回顾分析。结果全组病例均有发热、消瘦、乏力、食欲减退,咳嗽20例,气急18例,腹泻10例,发绀18例,淋巴结肿大10例,卡波肉瘤2例,肺部湿啰音22例,心动过速25例,脾肿大5例,外生殖器溃疡8例,尖锐湿疣5例,CD4+T淋巴细胞减少22例。并发症:肺结核8例,细菌性肺炎12例,肺部真菌感染4例,卡氏肺囊虫肺炎1例,马纳菲青真菌感染1例。肺部感染具多样性、混合性、播散性和难治性的特点,死亡22例,自动出院3例。结论艾滋病及其并发症的临床表现具有多样性,静脉注毒传染与性传染基本各占一半。     

颅内动脉瘤电解脱弹簧圈栓塞治疗术中破裂的可能性及其对策

目的探讨破裂动脉瘤在电解脱弹簧圈(Guglielmi detachable coil，GDC)栓塞术中再次破裂的可能性及其相应措施。方法159例颅内动脉瘤施行GDC栓塞时，发生术中再次破裂7例。女5例，男2例，平均年龄46．9岁：7例中微导丝原性破裂1例，弹簧丝原性破裂3例，微导管原性破裂2例，弹簧圈填塞过度性破裂1例。结果3例弹簧丝原性破裂和2例微导管原性破裂均施行GDC继续填塞或调整微导管位置后继续填塞，直至瘤腔致密填塞。该5例中4例术后完全康复，1例残留一侧下肢不灵便；1例微导丝原性破裂和1例弹簧圈过度填塞性破裂，因术中出血过多致死亡。结论颅内动脉瘤GDC栓塞中发生动脉瘤破裂难以避免，操作者经验与发生率成反比，材料选择合活可降低其发生率．破裂发生后继续GDC填塞可达到完全填寨、愈复。     

GrauerⅡ型齿状突骨折治疗方式选择及疗效分析

目的 探讨GrauerⅡ型(ⅡA、ⅡB、ⅡC型)齿状突骨折治疗方式的选择及临床疗效。 方法 本组共40例新鲜齿状突骨折患者,按照Grauer分型：ⅡA型7例,ⅡB型18例,ⅡC型15例;5例伴有不完全性脊髓损伤。7例ⅡA型患者先行枕颌带或颅骨牵引,后改用头颈胸石膏或支具外固定;15例ⅡB型患者行前路齿状突中空螺钉内固定;15例ⅡC型、3例严重移位ⅡB型患者经后路行寰枢椎椎弓根钉棒系统内固定植骨融合术。 结果 40例患者随访6～ 24个月。7例ⅡA型患者经保守治疗3-6个月骨折愈合。15例ⅡB型患者螺钉位置良好,未出现脊髓损伤,其中14例术后3～6个月骨性愈合,愈合率93.3％;15例ⅡC型、3例严重移位ⅡB型患者术中未出现椎动脉和脊髓损伤,后路植骨3～6个月骨性融合;复查内置物位置良好,无变形、松动或断裂;5例伴有脊髓不全损伤患者术后脊髓神经功能均有不同程度改善。 结论 Grauer分型中ⅡA型齿状突骨折可以保守治疗,ⅡB型(无移位或经牵引复位)宜行前路齿状突中空螺钉内固定术,ⅡC型及严重移位ⅡB型则应经后路行寰枢椎椎弓根钉棒系统内固定植骨融合术治疗。     

输尿管镜下钬激光治疗输尿管结石并发症发生的原因及对策(附11例分析)

目的 探讨输尿管镜下钬激光治疗输尿结石并发症的原因及预防措施.方法 回顾性分析对2005年8月至2006年3月136例输尿管镜下钬激光治疗输尿管结石出现11例并发症发生的原因及治疗措施.结果 11例并发症中输尿管黏膜撕脱2例,输尿管穿孔4例,输尿管下隧道1例,发热4例;发生率8.1%.并发症的发生与输尿管狭窄,激光击穿输尿管管壁、导管刺穿输尿管黏膜等有关.均经相应治疗获愈.结论 输尿管镜下的钬激光治疗输尿道结石、安全、有效、微创.但如果操作不当则会引起严重后果.提高操作技能及掌握相应的处理措施是降低输尿管镜下钬激光治疗泌尿系结石并发症的关键.     

Splenic artery and superior mesenteric artery blood flow: nonsurgical Doppler US measurement in healthy subjects and patients with chronic liver disease

The accuracy of the duplex Doppler ultrasound system in the measurement of blood flow in the splenic artery and the superior mesenteric artery was evaluated in seven anesthetized dogs by comparing blood flow recordings obtained simultaneously with the electromagnetic flowmeter, with those obtained with the combination of B-mode and M-mode scanning. Various flow rates were produced by the infusion of dopamine. Splenic artery blood flow and superior mesenteric artery blood flow measured with the duplex system exhibited significant correlations with corresponding values obtained with electromagnetic flow measurements (r = .93 and r = .93, respectively). Changes in splanchnic circulation with the progression of chronic liver disease in humans were then investigated with the use of the duplex system. Splenic artery blood flow and superior mesenteric artery blood flow were significantly increased in patients with cirrhosis compared with patients with chronic hepatitis and healthy subjects. These results indicate that a hyperdynamic circulatory state may develop in the splanchnic circulation of the intestine and spleen in cirrhotic patients.