Comparison of blood velocity waveform indices recorded by pulsed Doppler and continuous wave Doppler in the umbilical artery

A comparison was made between the AB ratio, resistance index (RI), and pulsatility index (PI), calculated from tracings obtained by pulsed Doppler (PD) and continuous wave (CW) Doppler devices in 14 uncomplicated singleton pregnancies. The AB ratio, RI, and PI were a slightly higher for the CW Doppler compared to the PD system, although not significantly (p = 0.18, p = 0.21, and p = 0.44, respectively). The difference in signal to noise ratio (S/N ratio) between the PD and CW Doppler systems was felt to be the reason for the discrepancy in the calculated velocity waveform indices.     

犬失血性休克及补液过程中肾动脉多普勒血流速度频谱形态、阻力指数、搏动指数的变化

为探讨失血性休克及补液治疗过程中肾动脉多普勒血流速度频谱形态、RI、PI的变化规律及应用价值，本研究将10条太经股静脉放血至休克状态。然后行补液治疗。在实验过程中按失血量定时检测犬肾动脉血流速度频谱，计算RI、PI值，并记录同步血压。结果：（1）失血过程中．肾动脉RI、PI值随着失血量的增加，血压的下降．总体呈现上升趋势。随着补液的进行、MAP逐渐回升，RI、PI逐渐下降；（2）频谱形态出现一些特民改变，如重度失血时频谱舒张期出现小峰及凹陷．补液早期频谱舒张期凸起等。结论：多普勒指标RI、PI能较好地反映肾动脉阻力情况，肾动脉RI、PI可作为临床大出血患者病情观察和疗效判断的实用指标。     

脉冲多普勒超声检测胎儿大脑中动脉的搏动指数

应用脉冲多普勒超声检测１１５例晚期妊娠胎儿大脑中动脉的搏动指数（ＭＣＡＰＩ）。正常胎儿ＭＣＡＰＩ随孕龄增长而下降，呈显著负相关。宫内发育迟缓（ＩＵＧＲ）组ＭＣＡＰＩ低于均值的二个标准差截止点水平的百分数（８３．８７％）显著高于正常组（４．７６％），以此截止点水平诊断ＩＵ－ＧＲ，敏感性为８３．８７％，特异性为９５．２３％，阳性预测值８６．６７％，阴性预测值９４．１２％。脉冲多普勒超声检测胎儿脑血流是一项有用的方法。     

同种异体肾移植患者肾功能变化与叶间动脉阻力指数和搏动指数变化的相关性分析

目的运用彩色多普勒超声测量移植肾叶间动脉的阻力指数(RI)和搏动指数(PI),观察两者的变化情况与肾功能变化的关系。方法在100例无并发症肾移植患者中,应用彩色多普勒超声,于肾移植术后1月测量移植肾叶间动脉的RI和PI。测定患者血清肌酐、非蛋白氮及血白蛋白,根据MDRD公式计算肾小球滤过率(GFR)。随访2年后再行一次上述超声和肾功能检查,比较叶间动脉RI、PI和肾功能的变化情况,作RI、PI变化值与GFR变化值的相关性分析。结果叶间动脉的RI和PI在随访前后与GFR无明显的相关,随访前后RI和PI的改变与GFR的改变呈明显的负相关。100例患者中,21例患者出现了肾功能异常,79例的肾功能仍然正常。根据2年后的肾功能有无异常将患者分为GFR正常组和GFR异常组。两组随访前后叶间动脉的RI和PI变化与GFR变化呈明显的负相关。结论多普勒彩超动态监测移植肾叶间动脉的RI和PI变化能够预测移植肾肾功能的变化。     

正常人舌体部动脉彩色多普勒超声应用研究

目的分析正常人舌体部动脉血流动力学特征,旨在探讨规范化探查舌动脉血流参数方法和建议。方法应用彩色多普勒血流显像(CDFI)对42例正常人进行舌深动脉血流参数进行测量,同一受试者采取坐位,仰卧位,并分别在吞咽前后测量。检测参数包括血管内径(D),收缩期峰值流速(PSV),舒张末期流速(EDV),阻力指数(RI)。结果仰卧位RI:0.79±0.06,坐位RI:0.83±0.05,P<0.05,差异有统计学意义;仰卧位吞咽前RI:0.79±0.06,吞咽后RI:0.59±0.05,P<0.01,差异有统计学意义;仰卧位吞咽前PSV:(30±5)cm/s,吞咽后PSV:(42±6)cm/s,P<0.01,差异有统计学意义。仰卧位吞咽后舌动脉RI值明显减低,PSV明显升高,表明吞咽后舌肌完全放松,而后RI值又逐渐升高,PSV逐渐减低,约3~4s达到相对稳定状态。结论建议舌动脉的血流参数的测量应选择于仰卧位,吞咽后(3.56±0.37)s。     

双功彩色多普勒超声对原发性高血压左室肥厚肾内动脉血流的评价

目的：应用双功彩色多普勒超声观察原发性高血压继发左室肥厚患者肾内动脉血流动力学的变化。方法：利用ＡＴＬＵＭ－９及ＨＰｓｏｎｏｓ－２５００超声仪检测了同一年龄组３２例正常人和３０例原发性高血压左室肥厚患者肾内动脉（段动脉、叶间动脉）的血流参数—收缩峰速度（Ｖｓｍａｘ）、舒张期最低流速（Ｖｄｍｉｎ）、阻力指数（ＲＩ）和加速度时间（ＡＴ）。结果：原发性高血压左室肥厚肾脏的段动脉和叶间动脉的ＲＩ、ＡＴ均较正常对照组明显增高（Ｐ均＜０．０１）。Ｖｓｍａｘ和Ｖｄｍｉｎ均明显低于对照组（ｐ均＜０．０１）。结论：原发性高血压左室肥厚患者肾内动脉（段动脉、叶间动脉）的收缩期和舒张期血流均处于低流速，肾血管处于高阻力状态。     

Relationship between Doppler pulsatility index and direct femoral pressure measurements in the diagnosis of aortoiliac occlusive disease

One hundred and seventy-five aortofemoral segments were studied in order to determine the role of CW Doppler ultrasound combined with real-time spectral analysis in the assessment of aortoiliac disease. The pulsatility index (PI), determined from the maximum velocity waveform, was compared to the systolic pressure difference between the aorta and common-femoral artery as measured at the time of angiography. Receiver operating characteristic curves were constructed and the optimum sensitivities and specificities measured. Results show that if a PI(max) of 5.5 is taken as the threshold level, then the PI is 95% sensitive and specific in detecting hemodynamically significant aortoiliac disease that corresponds to a resting aortofemoral pressure difference of 10 mm Hg or greater.We also carefully examine those technical aspects of Doppler recording and analysis that influence the accuracy of PI measurements     

Transcranial colour coded sonography as an aid to measurement of blood flow velocity in the basal cerebral arteries

Unlike conventional transcranial Doppler, transcranial colour coded sonography allows imaging of the basal cerebral arteries. We used this technique to determine blood flow velocities, with compensation for the angle of insonation, in the anterior and posterior cerebral circulation of 60 volunteers categorised by age (20–39, 40–59, > 60 years). Successful vessel insonation declined with increasing age: 40/40 middle cerebral arteries insonated 20–39 y, 31/40 insonated >60 y. Peak, mean and end diastolic blood flow velocities also decreased with age in all arteries: 20–39 y middle cerebral artery mean VELOCITY = 72 cm/s; > 60 y middle cerebral artery mean blood flow VELOCITY = 58 cm/s; p < 0.0001. The pulsatility index increased significantly with age in the middle, posterior cerebral (P2 segment) and vertebral arteries (p < 0.05-0.005), however the resistance index increased significantly with age in all vessels (p < 0.05-0.0001).     

增强型能量多普勒技术检测系统性红斑狼疮患者肾动脉血流动力学指数

目的 应用增强型能量多普勒（E-Flow）技术检测系统性红斑狼疮（SLE）患者肾内各级动脉血流动力学指数,评价E-Flow技术诊断SLE患者肾损害和判断预后的价值。方法 2012年5月至2013年3月哈尔滨医科大学附属第二医院收治的50例SLE患者,其中狼疮肾炎（LN）患者28例,非LN患者22例,另选择30名健康志愿者作为健康对照组。对所有入选者进行肾脏超声检查,观察肾脏的二维超声声像图并利用E-Flow技术分别测量肾脏段动脉、叶间动脉、弓状动脉、小叶间动脉的收缩期峰值流速（PSV）、舒张末期流速（EDV）以及阻力指数（RI）。采用方差分析比较健康对照组、非LN组与LN组段动脉、叶间动脉、弓状动脉、小叶间动脉PSV、EDV、RI差异,进一步组间两两比较采用LSD-t检验。采用一元线性相关分析判断LN组患者各级肾动脉的RI与血肌酐浓度的相关性。结果 非LN组患者肾脏的二维超声声像图均正常;LN组8例患者出现肾实质弥漫性改变。非LN组患者小叶间动脉的频谱与健康对照组受试者相似,舒张期充盈曲线稍减低;LN组患者小叶间动脉的频谱波峰圆钝,表现为高阻低灌注型频谱。LN组患者叶间动脉、弓状动脉、小叶间动脉的PSV均较健康对照组受试者降低,且差异均有统计学意义（t值分别为-2.46、-2.40、-3.49, P值均＜0.05或0.01）;LN组与非LN组患者各级肾动脉的EDV均较健康对照组降低,且差异均有统计学意义（LN组：t值分别为-5.50、-5.95、-5.83、-5.01,P值均＜0.01;非LN组：t值分别为-3.41、-3.69、-3.29、-2.49,P值均＜0.01或0.05）;其中LN组患者弓状动脉、小叶间动脉的PSV及EDV均较非LN组患者降低,且差异均有统计学意义（PSV：t值分别为-2.00、-2.16,P值均＜0.05;EDV：t值分别为-2.13、-2.16,P值均＜0.05）;LN组与非LN组患者各级肾动脉的RI均较健康对照组增高,且差异均有统计学意义（LN组：t值分别为12.78、13.30、11.95、9.52,P值均＜0.01;非LN组：t值分别为9.88、10.05、8.71、5.30,P值均＜0.01）;LN组患者各级肾动脉的RI均较非LN组患者增高,且差异有统计学意义（t值分别为2.05、2.38、2.43、3.57,P值均＜0.05或0.01）。同时,LN组患者各级肾动脉的RI均与血肌酐浓度呈正相关（r值分别为0.684、0.752、0.755、0.851,P值均＜0.01）。结论 E-Flow技术可清晰显示SLE患者肾动脉各级分支,并可通过测量血流动力学指数评估SLE患者的病情及预后。     

经阴道彩色多普勒系统显像及CA125联合诊断卵巢肿块良恶性的价值

本文报告１９９４年元月至９月经阴道彩色多普勒及血清卵巢癌相关抗原（ＣＡ１２５）检查，术后病理证实的卵巢肿块８０例，其中恶性肿瘤１７例，良性肿瘤６１例，卵巢结核２例。结果表明：恶性肿瘤内部ＲＩ平均值０．４２４５±０．０７１２，ＲＩ＜１，良性肿瘤内部ＲＩ平均０．６６±０．１０７７，ＲＩ＞１，而卵巢结核ＲＩ平均值０．４７６±０．０７５，ＲＩ＜１。如Ｒ１＜０．５，ＰＩ＜１作为恶性肿瘤标准，其诊断敏感性为８２．４％，特异性９８．４％，准确性９５％。ＣＡ１２５敏感性８０％，特异性７７．４％，准确性７８．３％，二者综合诊断价值更高。     

Effect of Velocity Profile Skewing on Blood Velocity and Volume Flow Waveforms Derived From Maximum Doppler Spectral Velocity

Given evidence that fully developed axisymmetric flow may be the exception rather than the rule, even in nominally straight arteries, maximum velocity (V_max) can lie outside the Doppler sample volume (SV). The link between V_max and derived quantities, such as volume flow (Q), may therefore be more complex than commonly thought. We performed idealized virtual Doppler ultrasound on data from image-based computational fluid dynamics (CFD) models of the normal human carotid artery and investigated how velocity profile skewing and choice of sample volume affected V_max waveforms and derived Q variables, considering common assumptions about velocity profile shape (i.e., Poiseuille or Womersley). Severe velocity profile skewing caused substantial errors in V_max waveforms when using a small, centered SV, although peak V_max was reliably detected; errors with a long SV covering the vessel diameter were orientation dependent but lower overall. Cycle-averaged Q calculated from V_max was typically within ±15%, although substantial skewing and use of a small SV caused 10%–25% underestimation. Peak Q derived from Womersley's theory was generally accurate to within ±10%. V_max pulsatility and resistance indexes differed from Q-based values, although the Q-based resistance index could be predicted reliably. Skewing introduced significant error into V_max-derived Q waveforms, particularly during mid-to-late systole. Our findings suggest that errors in the V_max and Q waveforms related to velocity profile skewing and use of a small SV, or orientation-dependent errors for a long SV, could limit their use in wave analysis or for constructing characteristic or patient-specific flow boundary conditions for model studies.     

2型糖尿病肾内多普勒血流超声检查的临床价值

目的探索2型糖尿病病人不同病程、血糖水平肾内血流参数的价值。方法E saotMegnsGpx超声仪检测90例2型糖尿病病人及正常对照组90例的肾内收缩期Vs、舒张期Vd和肾内各分支动脉的阻力指数磁的血流参数。结果对照组（Ⅰ组）与1～5年组（Ⅱ组）、6～10年组（Ⅲ组）、≥11年组（Ⅳ组）Vs、Vd、RI流速度差异有显著性（P〈0．01）。结论肾内彩色多普勒血流测定提示诊断和预测早期肾损害的简便易行、可靠的方法。     

Comparative study of four methods for quantifying doppler ultrasound waveforms from the femoral artery

Currently, there is no agreement as to the best method for quantifying Doppler ultrasound recordings from peripheral arteries in order to detect occlusive disease. The four methods assessed in this study are: the pulsatility index, height-width index, path length index, and a Laplace transform function index. Recordings of the Doppler ultrasound spectral waveforms from the common femoral artery of 232 limbs were digitized to obtain the maximum velocity waveforms. This data was analyzed and the various indices were computed and then compared with the arteriographic grades. The effect of distal disease was also examined. The diagnostic accuracy of each index was determined from receiver operating characteristic curves. We concluded that all four indices were capable of detecting significant aortoiliac disease with approximately equal diagnostic accuracy of 90–95% but that pulsatility index had the advantages of simplicity and ease of calculation.     

羊水过多胎儿血流变化的临床研究

目的探讨羊水过多胎儿血流的变化。方法对１３例足月妊娠羊水过多应用彩色多普勒显像技术（ＣＤＦＩ）检测胎儿肾动脉,大脑中动脉的搏动指数（ＰＩ）、阻力指数（ＲＩ）以及脐动脉Ｓ／Ｄ。结果羊水过多胎儿肾动脉ＰＩ、ＲＩ明显高于正常羊水量对照组（Ｐ＜０．０５）;大脑中动脉ＰＩ、ＲＩ,脐动脉Ｓ／Ｄ值两组比较无显差异（Ｐ＞０．０５）。结论羊水过多与胎儿肾动脉血流有明显相关性,其胎儿肾动脉血流阻力改变在羊水过多中的     

Measurement of blood flow velocity in the basal cerebral circulation: Advantages of transcranial color-coded sonography over conventional transcranial doppler

Unlike conventional transcranial Doppler (TCD), transcranial color-coded sonography (TCCS) enables imaging of the basal cerebral arteries using color-flow ultrasonography and correction for the angle of insonation when determining blood flow velocities. We present hemodynamic data from 20 normal subjects, each studied with TCD and TCCS. Velocities derived using TCCS with angle correction were significantly greater than those derived using TCD in all vessels (mean velocities [cm/sec; mean with 95% confidence intervals])—anterior cerebral artery: TCD 48 (45–50), TCCS 62 (58–66), p < .0001; middle cerebral artery: TCD 61 (58–64), TCCS 70 (66–74), p < .0001; posterior cerebral artery: TCD 43 (41–46), TCCS 54 (50–57), p < .0001; basilar artery: TCD 40 (34–45), TCCS 45 (38–52), p <.01. Pulsatility index values were significantly greater in all arteries when determined by TCCS, and resistance index values were significantly greater except in the basilar artery. Correcting for the angle of insonation using TCCS may enable estimation of blood flow velocities closer to the “true” values than those derived using conventional TCD. © 1995 John Wiley & Sons, Inc.     

二维及彩色多普勒超声对子宫肌瘤和腺肌病的诊断价值

目的 评价二维超声及彩色多普勒血流显像对子宫肌瘤和子宫腺肌病的诊断价值。方法 40例子宫肌瘤和47例子宫腺肌病患于手术前3d内行二维超声及彩色多普勒超声检测，术后经病理组织学验证。结果 40例子宫肌瘤中7例和47例子宫腺肌病中8例二维超声显示结构异常，28例子宫肌瘤和11例子宫腺肌病RI≤0．7，30例子宫肌瘤和9例子宫腺肌病PI≤1．17，三的敏感性分别为82．5％、70．0％、75．0％，特异性分别为83．0％、76．6％、80．9％。结论 以二维超声作为诊断基础，结合彩色多普勒超声，多参数综合评价可提高子宫肌瘤和子宫腺肌病的诊断率。     

The relationship between blood flow and pulsatility index in the superior mesenteric artery at rest and during constrictor stimuli in normal subjects

The relationships between superior mesenteric artery blood flow (SMABF) and pulsatility index (PI) measurement during rest (25 subjects) and stimuli constricting the SMA (16 subjects) have been studied in normal subjects. At rest and during constrictor stimuli, SMABF and PI were highly reproducible (r = 0.89, p < 0.01 for SMABF, and r = 0.97, p < 0.001 for PI) between two observers. There was significant correlation between changes in SMABF, PI, and SMA vascular resistance during the constrictor stimuli, except during head-up tilt when PI was unchanged. Both PI and SMABF measurements are reproducible and can be used to monitor physiological changes in suitable (18 of 25) subjects. PI measurement, although semiquantitative, by itself can also be used to monitor these changes. This may be also of importance in pathological situations such as intestinal ischemia, where measurement of volume blood flow may be less accurate due to irregularities of the vessel wall. PI measurement, however, ideally should not be used in studies involving postural change. © 1994 John Wiley & Sons, Inc.     

正常孕妇的肝静脉和门静脉多普勒频谱的观测

本文利用双功多普勒观测63名正常孕妇在妊娠各期肝静脉血流频谱、门静脉血流动力学变化情况，并与100名育龄期健康非孕妇女对比，根据多普勒频谱特点将肝静脉波形分为正常型、衰减型、平坦型。结果：孕妇门静脉血流速度及血流量明显高于非孕妇（P＜0．001）；非孕妇肝静脉波形均为正常型；正常孕妇肝静脉血流频谱振幅降低以至消失，随着孕周增加频谱改变越明显（P＜0．001），孕1～12周正常型占79％，衰减型占18％，平坦型占3％，孕12～28周正常型占37％，衰减型占22％，平坦型占41％，孕28～40周正常型占6％，衰减型占11％，平坦型占83％。因而，不能一概认为正常肝静脉频谱变化均由病理因素引起。     

A combined ultrasonic linear array scanner and pulsed Doppler velocimeter for the estimation of blood flow in the foetus and adult abdomen--I: Technical aspects

A method is proposed for estimating the volume blood flow of deep lying vessels in the foetus and in adult portal vein and renal vessels. The equipment combines a 3.5 MHz linear array scanner with a 2 or 4 MHz pulsed Doppler. The pulsed Doppler tranducer is connected to the linear array by two movable arms. A real time spectrum analyser is used to process the Doppler signals. A water bath was used to perform an in vitro calibration of the complete system and to adjust the registration of the Doppler sample volume with the echo picture. Several possible inaccuracies in vessel diameter measurement are discussed and the mean of several caliper measurements described by Eik-Ness (1982) is used. Time Motion is thought to be the better method but is more complicated in practice.