Left ventricular dynamics in hypertrophic cardiomyopathy by Color Doppler Flow Imaging

Abstracts

Left ventricular dynamics in hypertrophic cardiomyopathy by Color Doppler Flow Imaging     

Patterns of Flow Within the Dilated Cardiomyopathy Left Ventricle: Color Flow Doppler Observations

Study of the pathways of intraventricular flow by pulsed Doppler and color flow Doppler has shown that, in normal individuals, a broad strong stream flows into the left ventricular chamber from the mitral annulus to the apex during early rapid and late (atrial) ventricular filling phases; in systole, a broad rapid stream from the apex to the aortic orifice is dominant. In dilated cardiomyopathy, flow velocities are slower, and the typical pattern is a circular type of diastolic flow along the lateral left ventricular wall toward the apex and then from the apex to the aortic orifice along the septum. The systolic flow pattern is also different in dilated cardiomyopathy; in addition to the flow along the septum toward the aortic orifice, some blood flows in a circular manner back to the apex along the lateral wall. An important aspect of abnormal flow patterns in dilated dysfunctional left ventricular chambers is their association with a tendency to thrombus formation. Thus, the pathophysiology of abnormal intraventricular flow patterns may have academic but also therapeutic implications. (ECHOCARDIOGRAPHY, Volume 8, March 1991)     

彩色多普勒超声在结节性甲状腺肿中的诊断价值

目的探讨彩色多普勒超声在结节性甲状腺肿(简称结甲)诊断中的价值。方法回顾88例结节性甲状腺肿的声像图与手术病理诊断对照分析。结果88例经手术病理证实的结甲,术前超声诊断的79例(诊断符合率90%),误诊为甲状腺腺瘤6例、甲状腺癌2例、亚急性甲状腺炎1例。结论结甲声像图表现复杂多样,超声检查虽具有一定特征性,但应注意鉴别诊断,以提高诊断符合率。     

彩色多普勒超声在原发性甲状腺功能减退症中的诊断价值

目的：探讨彩色多普勒血流显像（CDFI）在原发性甲状腺功能减退症（简称原发性甲减）诊断中的价值。方法：对经临床及实验室确诊的53例原发性甲减患进行彩色超声检查，对其声像图及血流特点进行分析。同时，我们选择了50例无甲状腺及其他内分泌代谢异常疾病的健康人作为对照。结果：在原发性甲减中71.7％的患甲状腺各径线无均减小，67.9%的患甲状腺内血流信号减少。结论：CDFI可以提供无创性诊断甲减的可靠依据，同时可以估测病变程度及判定预后。     

彩色多普勒血流显像对心房间隔缺损诊断的评价

目的：探讨彩色多普勒超声心动图诊断心房间隔缺损的临床价值。方法：以彩色多普勒血流显像技术对７５例患者的心房间隔缺损定位及估测缺损大小，并测定肺动脉收缩压。结果：７５例患者中，５２例经手术证实。彩色多普勒超声心动图诊断心房间隔缺损的敏感性达１００％；对缺损的定位准确率为９４．２％（４９／５２）；对缺损大小的估测与手术结果呈显著正相关（ｒ＝０．９５，Ｐ＜０．００１）。对Ｍ型超声心动图显示疑有肺动脉高压的２３例患者用三尖瓣反流压差法估测的肺动脉收缩压与心导管测值密切相关（ｒ＝０．８８，Ｐ＜０．００１）；同时计算肺动脉与主动脉根部内径比值与心导管测值比较，发现肺动脉与主动脉根部内径比值≥１．３５，提示肺动脉高压。结论：彩色多普勒超声心动图对心房间隔缺损有术前诊断价值，并能评价手术效果，可替代有创性检查。     

小肝癌彩色多普勒血流图像及术中B超诊断

本文报道应用彩色多普勒血流图像（CDFI）及术中B超（IOUS）诊断小肝癌9例，显示小肝癌的肿瘤内外动脉血流图像占88．8％（8／9），动脉阻力指数（ARI）均＞60％（范围68％－89％），网篮征55．5％（5／9）。其它小 占位性病变（血管瘤，炎性假瘤，脂肪瘤，肝囊肿，肝结核），CDFI，ARI＞60及网篮征检出率明显低于小肝癌（P＜0．01）。具有鉴别诊断意义，本组CDFI对小肝癌诊断率为88．8％（8／9），1例漏诊，由IOUS诊断，肿瘤为位于右叶后方上段，＜2.0cm的病例。CDFI具有无创性，操作简便，血流图像检出率高等特点，从而进一步提高超声诊断的特异性。IOUS可进一步辅助CDFI诊断的不足，特别是对AFP阴性，瘤体位于盲区的小肝癌。     

The Diagnostic Value of Superb Microvascular Imaging (SMI) in Detecting Blood Flow Signals of Breast Lesions: A Preliminary Study Comparing SMI to Color Doppler Flow Imaging

The correlation between color Doppler flow imaging (CDFI) and Superb Microvascular Imaging (SMI) for detecting blood flow in breast lesions was investigated, as was the diagnostic value of SMI in differentiating benign from malignant breast lesions.These lesions were evaluated using both CDFI and SMI according to Adler''s method. Pathologic examination showed 57 malignant lesions and 66 benign lesions. The number of blood vessels in a single mass was detected by 2 techniques (SMI and CDFI), and the difference between the 2 values (SMI-CDFI) was calculated. The optimal threshold for the diagnosis of malignant neoplasms and the diagnostic performances of SMI, CDFI, and SMI-CDFI were calculated.For the total lesions and malignant lesions alone, the difference between SMI and CDFI for detecting blood flow was significant (P < 0.01), but the difference was not significant for benign lesions (P = 0.15). The area under the receiver operating characteristic curve was 0.73 (95% confidence interval [CI]: 0.64–0.82) for CDFI; 0.81 (95% CI: 0.74–0.89) for SMI; and 0.89 (95% CI: 0.82–0.95) for SMI-CDFI. Furthermore, the modality of “SMI-CDFI” showed the best diagnostic performance.SMI provides further microvessel information in breast lesions. The diagnostic modality of “SMI-CDFI” can improve the diagnostic performance of ultrasound in the differentiation between benign and malignant masses.     

Intrahepatic Portosystemic Venous Shunt: Diagnosis by Color Doppler Imaging

Intrahepatic portosystemic venous shunt is a rare clinical entity; only 33 such cases have been reported. It may be congenital, or secondary to portal hypertension. Five patients with this disorder are presented, each of whom was diagnosed by color Doppler imaging, including waveform spectral analysis. One patient with clinical evidence of cirrhosis and portal hypertension had episodes of hepatic encephalopathy and elevated blood levels of ammonia. This patient had a large tubular shunt between the posterior branch of the portal vein and the inferior vena cava. Shunts of this type are considered to be collateral pathways which develop in the hepatic parenchyma as a result of portal hypertension. The other four patients had no evidence of liver disease, and all four evidenced an ancurysmal portohepatic venous shunt within the liver parenchyma. Shunts of this type are considered congenital. The diagnosis of intrahepatic portosystemic venous shunts was established by color Doppler imaging, which demonstrated a direct communication of color flow signals between the portal vein and hepatic vein, in addition to the characterization of the Doppler spectrum at each sampling point from a continuous waveform signal (portal vein) to a turbulent signal (aneurysmal cavity), and finally, to a biphasic waveform signal (hepatic vein). As demonstrated by the five patients, color Doppler imaging is useful in the diagnosis of an intrahepatic portosystemic hepatic venous shunt, and the measurement of shunt ratio may be useful in the follow-up and determining the therapeutic option.     

彩色多普勒能量图对慢性肾功能不全患者肾血流动力学研究

应用彩色多普勒能量图(CDEI)研究慢性肾功能不全肾血流分布、频谱特征及血流参数检测,旨在对临床医生分析病情、疗效及预后提供参考及疾病鉴别.方法 检测30例正常组和60例肾功能不全的肾脏,根据肾内血管显像水平,将CDEI分为四型.结果 慢性肾功能不全主肾动脉及分支血流信号分布有逐渐减弱甚至消失.肾动脉血流参数表明,从主肾动脉及分支血流速度逐渐明显降低,阻力指数较大,搏动指数增大.结论 本组结果表明,慢性肾功能不全患者,肾动脉分支血流分布,频谱特征及血流信号的分布,频谱形态的变化特征及血流参数的异常,可初步判断肾血流及肾功能状态,迅速了解病情、监测治疗、评估预后,为临床医生提供更加完善的依据.