彩色多普勒对眼球血管血流显像检测方法的探讨

目的：探讨眼球后血管血流显像的最佳位置。方法：应用彩色多普勒超声(CDFI)技术检测80例(160只眼)受试者视网膜中央动脉、静脉，睫状后短动脉，眼动脉的血流显像。结果：OA及CRA显示率近乎100％，PCA显示率为92％。结论：检测最佳部位分别是：CRA在视神经暗区内视盘后2mm，PCA在视神经暗区颞侧球内壁后5mm，OA在视神经暗区鼻侧球内壁后13mm外。     

CDFI对高眼压性青光眼血流动力学改变的分析

本文应用彩色多普勒成像(CDFI)技术分析了高眼压性青光眼53例(眼)眼动脉、视网膜中央动脉、睫状后短动脉的血流动力学收缩期峰值血流速度(PSV)、舒张期血流速度(EDV)及阻力指数(RI),并与正常人36例(眼)进行了对比。结果表明,高眼压性青光眼患者眼压越高,PSV、EDV值越低,RI值越高,对照组比较相差显著。眼压与PSV、EDV成负相关,与RI呈正相关。提示,眼动脉、视网膜中央动脉、睫状后短动脉的血流动力学参数PSV、EDV、RI可作为高眼压性青光眼患者视神经损伤的早期予警和晚期预后的判定依据之一。     

彩色多普勒成像技术对近视眼眼部血流动力学研究

目的:观察近视眼的血流动力学改变,及与眼轴、眼压等的关系。方法:应用彩色多普勒超声诊断仪对中度近视(26例,52只眼)、高度近视(23例,44只眼)患者和正常人(25例,50只眼)的眼动脉、睫状后短动脉、视网膜中央动脉的收缩期峰值流速(PSV)、舒张期最小流速(EDV)和阻力指数(RI)以及眼轴、眼压等进行检测。结果:近视眼患者眼动脉的PSV、EDV及RI与正常人相比无显著性差异(P>0.05);视网膜中央动脉和睫状后短动脉的PSV、EDV比正常人低(P<0.05),RI比正常人高(P<0.05);中度近视眼组与高度近视眼组比较,睫状后短动脉的EDV、视网膜中央动脉的EDV、RI有显著性差异(P<0.05);近视眼眼轴、眼压与正常人相比亦有显著性差异(P<0.05)。结论:近视眼眼底血管视网膜中央动脉、睫状后短动脉血流动力学改变是屈光度进一步加深、视功能损害的重要原因之一。     

超声分析病理性近视眼球后血流变化及其与病理性近视特征性改变的关系

目的应用超声分析病理性近视眼球后血流变化特征,探讨其与病理性近视特征性改变(最佳矫正视力、屈光度、眼轴及视网膜脉络膜萎缩等)的关系。方法选取20例正常视力者(正常组,40只眼)、20例中低度近视者(中低度近视组,40只眼)及20例病理性近视者(病理性近视组,40只眼),应用彩色多普勒超声记录其等效球镜度数、眼轴、最佳矫正视力、视网膜脉络膜萎缩程度及眼球后多普勒血流参数,并对病理性近视眼球后血流行偏相关性分析。结果病理性近视组与中低度近视组和正常组比较,眼动脉舒张末期血流速度(EDV)、阻力指数(RI)、视网膜中央动脉收缩期峰值血流速度(PSV)、EDV、RI,以及睫状后动脉PSV、EDV、RI差异均有统计学意义(均P0.05);中低度近视组各参数与正常组比较差异均无统计学意义。偏相关性分析显示视网膜中央动脉PSV与眼轴和年龄均呈负相关(r=-0.40、-0.33,均P0.05),RI与年龄呈负相关(r=-0.43,P0.05),睫状后动脉PSV与年龄、最佳矫正视力及视网膜脉络膜萎缩程度均相关(r=-0.57、0.43、-0.42,均P0.05)。结论病理性眼球后血流的改变具有一定特征性,其与眼轴、最佳矫正视力及视网膜脉络膜萎缩程度均有一定相关性。     

彩色多普勒超声对正常眼压性青光眼血流动力学的研究

目的研究正常眼压性青光眼视神经的血液供应状况。方法用彩色多普勒超声检测正常眼压性青光眼和正常眼眼动脉、视网膜中央动脉和睫状后短动脉的收缩期峰值血流速度（PSv）、舒张末期血流速度（EDV）、阻力指数（RI）。结果正常眼压性青光眼组中眼动脉（OA）、视网膜中央动脉（CRA）、睫状后短动脉（SPCA）的PSV、EDV较正常对照组减慢,差异具有统计学意义（t分别=2．83、4．57、2．94、3．17、6．69、5．22,P均〈0．05）;OA、CRA、SPCA的RI较正常对照组增高,差异具有统计学意义（t分别=2．75、2．94、2．89,P均〈0．05）。结论正常眼压性青光眼的视神经存在缺血因素,彩色多普勒超声对其早期诊断有重要价值。     

糖尿病患者眼动脉、视网膜中央动脉和睫后短动脉血流参数变化的研究

目的：利用的彩色多普勒技术测量并研究糖尿病视网膜病变（DR）中眼动脉、视网膜中央动脉和睫后短动脉的血流参数的变化。方法：测量不同程度DR病人的眼动脉、视网膜中央动脉和睫后短动脉收缩峰值流速（PSV）、舒张末期速度（EDV）和阻力指数（RI）。结果：所有DR和重度DR的OA的CRA中PSV。重度DR的CRA和PCA的EDV，所有DR中CRA和PCA的RI与健康对照组对比具有统计学意义。结论：视网膜中央动脉是DR中的血流动力学变化的敏感指标。彩色多普勒超声是评价糖尿病视网膜病变时眼内动脉血流动力学变化的有效方法。     

彩色多普勒超声在放射性视神经病变中的应用

目的 分析放射性视神经病变患者眼球的声像图特征和视网膜中央动脉的血流动力学特点,探讨彩色多普勒超声在放射性视神经病变中的应用价值.方法 应用二维超声对27只确诊为放射性视神经病变的眼球进行检查,彩色多普勒超声观察其视网膜中央动脉的血流动力学特点,包括收缩期峰值流速（PSV）、舒张末期流速（EDV）、阻力指数（RI）及搏动指数（PI）,并与40只正常健康眼球进行对照分析.结果 7只眼玻璃体无明显浑浊,11只眼玻璃体浑浊,4只眼玻璃体积血,4只眼玻璃体增生膜形成,1只眼牵拉性视网膜脱离,放射性视神经病变患者的PSV、EDV显著低于正常对照组（P〈0.05）.结论 放射性视神经病变患者的视网膜中央动脉血流速度、血管充盈度降低,彩色多普勒超声对放射性视神经病变有重要的诊断价值     

乙肝后肝硬化患者球后血流变化的彩色多普勒研究

目的　采用CDFI技术检测乙肝后肝硬化患者球后血流，旨在推断其高动力循环的程度。方法不测量32例正常成人、86例乙肝后肝硬化患者眼动脉、睫状后动脉、视网膜中央动脉的RV、EDV、RI。结果　乙肝后肝硬化肝功能B、C级组和脾切除术后组的PSV、EDV均升高，RI降低；肝功能A级组仅RI降低。结论　①乙肝后肝硬化肝功能A级组球后血管各血流参数仅阻力指数减低，说明RI是早期反映球后血流变化参数中的灵敏指标。②乙肝后肝硬化肝功能B级组、C级组球后血管PSV、EDV有不同程度升高，且以EDV升高为著；RI显著减低，说明乙肝后肝硬化高动力循环状态也存在于外周末梢动脉血管。     

红花注射液经眼部皮肤离子导入对眼部动脉血流动力学影响的超声观察

目的应用超声评价红花注射液经眼部皮肤离子导入治疗后眼部动脉血流动力学变化情况。方法选取我院体检健康者40例,共80只眼,右眼均用面纱浸湿红花注射液20 ml,覆盖右眼部皮肤(治疗组);左眼均用面纱浸湿生理盐水20 ml,覆盖左眼部皮肤(对照组),两组同时采用离子导入仪治疗20 min。应用彩色多普勒超声检测两组治疗前后视网膜中央动脉、睫状动脉、眼动脉的收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI),并对比分析。结果治疗组经红花注射液离子导入治疗后视网膜中央动脉、睫状动脉、眼动脉的PSV和EDV分别为(14.93±2.36)cm/s和(4.81±1.03)cm/s、(14.74±2.64)cm/s和(5.36±1.10)cm/s、(35.91±6.71)cm/s和(8.13±2.36)cm/s,PSV与EDV差值亦增加,与治疗前比较差异均有统计学意义(均P0.05);仅RI治疗前后比较差异无统计学意义。对照组视网膜中央动脉、睫状动脉、眼动脉各参数治疗前后比较差异均无统计学意义。结论中药制剂红花注射液经眼部皮肤离子导入治疗可改善眼部动脉血供;彩色多普勒超声能够为该方法治疗眼部疾病提供客观的血流动力学依据。     

2型糖尿病非增殖期黄斑水肿患者眼球后动脉血流动力学的超声评价

目的探讨彩色多普勒超声评价糖尿病视网膜病变非增殖期黄斑水肿患者眼球后动脉血流动力学的价值。方法选取2型糖尿病非增殖期黄斑水肿患者30例(46只眼)为病例组,2型糖尿病非增殖期视网膜病变患者30例(60只眼)为对照组,应用彩色多普勒超声检测两组视网膜中央动脉(CRA)、眼动脉(OA)、睫状后短动脉(PCA)的血流参数,并对其结果进行对比分析。绘制受试者工作特征(ROC)曲线分析各血流参数对糖尿病黄斑水肿的诊断价值。结果病例组CRA、PCA血流频谱均较对照组低平、圆钝,病例组OA血流频谱与对照组相似。病例组CRA的收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)均较对照组减低,差异均有统计学意义(均P<0.05);病例组PCA的PSV、EDV均较对照组减低(均P<0.05),RI与对照组比较差异无统计学意义;病例组OA的各血流参数与对照组比较差异均无统计学意义。以CRA的PSV 7.655 cm/s、EDV 2.925 cm/s及RI 0.645为截断值,诊断黄斑水肿的敏感性分别为80.0%、60.7%及63.8%,特异性分别为76.1%、76.1%及70.0%,曲线下面积分别为0.783、0.720及0.692。以PCA的PSV8.75 cm/s、EDV 2.56 cm/s为截断值诊断黄斑水肿的敏感性分别为75.0%、81.3%,特异性分别为61.4%、60.9%,曲线下面积分别为0.536、0.533。结论彩色多普勒超声可以监测糖尿病非增殖期黄斑水肿患者眼球后动脉血流动力学的改变,为临床早期治疗提供可靠依据。     

彩色多普勒超声对甲状腺相关眼病的诊断价值

目的探讨彩色多普勒超声(CDFI)对甲状腺相关眼病(thyroid-associatedophthalmopathy,TAO)的诊断价值。方法应用二维及彩色多普勒超声分别检测30例TAO患者眼内、外直肌厚度,眼动脉收缩期最高流速(Vmax)、阻力指数(RI),并与正常对照组进行比较分析。TAO组各项参数与临床活动度评分(Clinicalactivityscore,CAS)进行相关分析。结果TAO组眼内、外直肌厚度,眼动脉收缩期血流最高流速与正常组比较差异有显著性(P<0.01),RI无明显差异。TAO组眼动脉收缩期最高流速与CAS呈正相关(左眼r=0.71,P<0.01;右眼r=0.67,P<0.01),眼内、外直肌厚度、RI与CAS相关性无统计学意义。结论彩色多普勒超声眼直肌测定能作为TAO临床诊断的辅助手段,眼动脉收缩期最高流速与TAO活动性相关性较好,能较准确地反映TAO临床活动性。     

彩超对视网膜中央静脉阻塞血流动力学改变的诊断价值

目的分析彩色多普勒超声在视网膜中央静脉阻塞(CRVO)分期的视网膜中央动脉血流动力学改变,评价视网膜中央动脉流速曲线参数的超声征象及诊断价值。方法应用彩超分别对CRVO非缺血型组48例(病变眼49只),缺血型组44例(病变眼48只)行视网膜中央动脉流速曲线参数的检测。另选择动脉硬化患者85例为对照组进行对比研究。结果CRVO组与对照组各项血流参数比较,舒张末期流速(EDV)下降(p<0.01)。视网膜中央动脉阻力指数(RI)增高(p<0.01),收缩期流速峰值(PSV)无明显差异(p>0.05)。缺血型组与非缺血型组各项血流参数比较,两组间的血流参数,经X2检验(p<0.01)有显著差异。结论随着CRVO的程度增加,视网膜中央动脉RI增高,视网膜缺血状态越明显,两者呈正相关。而EDV降低,呈较明显的低灌注、高回流状态。应用彩超评价CRVO对视网膜中央动动脉血流动力学改变,对诊断提供了可靠的依据。     

糖尿病视网膜血管病变彩色多普勒超声检测与血浆同型半胱氨酸的关系探讨

目的观察糖尿病视网膜病变时,彩色多普勒超声检测眼动脉(OA),视网膜中央动脉(CRA)和睫状后动脉(PCA)等血流参数,探讨同型半胱氨酸(Hcy)血症与视网膜病变之间的关系。方法同步检测30例正常人,55例糖尿病视网膜病及45例无视网膜病变者的OA、CRA和PCA的彩色多普勒超声以及血浆Hcy水平。结果视网膜病变组中CRA的收缩期峰值流速PVS、舒张期末流速(EDV)、阻力指数(RI)以及PCA中的EDV和RI与正常对照组相比,有明显差异;视网膜病变组中的血糖、Hcy明显升高。结论彩色多普勒超声检查对评估视网膜病变时CRA和PCA的血流动力学变化是一种有效的方法,高Hcy和视网膜病变的发生密切相关,是一种高危因素。     

Evaluation of ocular arterial changes in glaucoma with color Doppler ultrasonography.

The purpose of this study was to evaluate hemodynamic changes of the retrobulbar vasculature caused by different intraocular pressures with color Doppler ultrasonography. Fifty normal eyes in 25 patients, 13 patients with normal tension glaucoma, and 19 patients with acute glaucoma and increased intraocular pressure (greater than 30 mm Hg) were enrolled in this study. In 15 of 19 patients with acute glaucoma patients, follow-up color Doppler ultrasonography was also undertaken after laser peripheral iridectomy when the intraocular pressure had returned to normal. The peak systolic velocity, end diastolic velocity, resistive index, time average maximum velocity, and pulsatility index were compared in different vessels, including the central retinal artery, lateral posterior ciliary artery, medial posterior ciliary artery, and ophthalmic artery in each orbit. The peak systolic velocity, end diastolic velocity, and time average maximum velocity of the central retinal artery were significantly lower (P<0.01) in acute glaucoma patients than in the control group. The resistive index and pulsatility index of the central retinal artery were significantly higher (P<0.01) in acute glaucoma patients than in the control group. The end diastolic velocity of the lateral and medial posterior ciliary arteries was significantly lower in patients with acute glaucoma than in the control group, and the resistive index and pulsatility index of both of these arteries were significantly higher (P<0.001) in patients with acute glaucoma than in the control group. However, no statistical significantly differences were found in the peak systolic velocity or time average maximum velocity in either of the posterior ciliary arteries; similarly, no statistically significant differences were noted in any of the parameters in the ophthalmic artery between the control group and the group with acute glaucoma. The pulsatility index of the central retinal artery and of the lateral and medial posterior ciliary arteries was significantly lower (P<0.01) in acute glaucoma patients after laser therapy than in acute glaucoma patients before laser therapy. The resistive index of both posterior ciliary arteries was also significantly lower (P<0.004) in acute glaucoma patients after laser therapy than before laser therapy. All parameters for all vessels examined among the normal subjects, the patients with normal tension glaucoma, and the patients with acute glaucoma after laser therapy when the intraocular pressure had returned to normal showed no statistically significant differences. Color Doppler ultrasonography is a good modality for both imaging and studying the hemodynamics of the perioptic nerve vessels.     

Color Doppler imaging of the eye: normal ranges,reproducibility, and observer variation.

Color Doppler ultrasonography has numerous potential applications in the diagnosis and monitoring of many ocular disease processes. One of its advantages over other investigative and diagnostic tests is its safety and repeatability. To be able to fully assess this technique it is important to have good control data and to know the reproducibility of the technique for each of the retrobulbar vessels. Color Doppler ultrasonography was performed on 80 volunteers, and normal ranges of blood velocity were calculated for the ophthalmic artery and for the central retinal artery and vein. Reduction in the peak systolic and end diastolic velocities in the ophthalmic artery and an increase in resistive index in the central retinal artery and vein were noted with advancing age. With regard to reproducibility of the retrobulbar vessels, 15 healthy persons were chosen at random and intra- and interobserver studies performed. The most reliable and reproducible vessels were the ophthalmic artery and central retinal artery and vein. Greater variation was noted in the posterior ciliary vessels, whereas the superior ophthalmic and vortex veins were unreliable in both detection and velocity measurement. The results provide normal ranges for future studies and demonstrate that reproducible results can be obtained for the orbital vasculature using color Doppler imaging.     

彩色多普勒超声对糖尿病患者视网膜中央动脉和睫状动脉血流动力学的研究

目的:研究糖尿病患者视网膜中央动脉(CRA)、睫状动脉(PCA)的血流变化规律以及视网膜中央动脉血流参数与糖化血红蛋白(GHb)间的相关性。材料与方法:彩色多普勒超声检测67例(67只右眼)糖尿病患者和40例正常对照者的CRA、PCA的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI),同时检测患者GHb水平,分析CRA血流参数与GHb的关系。结果:糖尿病各组随病情的加重,CRA、PCA的血流速度呈逐渐减低趋势,RI呈增高趋势;且在无视网膜病变时就存在眼血流动力学的异常,CRA改变明显于PCA;GHb与CRA血流速度呈负相关,与RI呈正相关。结论:在无视网膜病变时,糖尿病患者不仅视网膜而且脉络膜都表现出血流动力学的异常,GHb水平与CRA血流参数有密切的相关性。     

Doppler measurement of blood flow velocities in extraocular orbital vessels in patients with obstructive sleep apnea syndrome

PURPOSE: We used color Doppler sonography to determine blood flow velocities in the extraocular orbital vessels of patients with obstructive sleep apnea syndrome (OSAS) and compared the results with those of healthy control subjects without OSAS. METHODS: Patients with OSAS were classified according to the apnea-hypopnea index (AHI) as having mild OSAS (AHI < 20) or severe OSAS (AHI > or = 20). The peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index were measured in the ophthalmic artery (OA), central retinal artery (CRA), lateral short posterior ciliary artery, and medial short posterior ciliary artery using color Doppler sonography. Only 1 eye was measured in each study participant, and right and left eyes were chosen randomly. The blood flow velocities of patients with OSAS and those of control subjects were compared with the Kruskal-Wallis test and Wilcoxon's rank-sum test. RESULTS: The study comprised 30 patients (15 with mild and 15 with severe OSAS) and 20 healthy control subjects. Blood flow velocities were higher in most measured vessels in patients with OSAS than they were in the control subjects. Among patients with mild OSAS, the PSVs and EDVs in the posterior ciliary arteries were statistically significantly higher than those of the control group (p < 0.05), but those in the OA and CRA did not differ significantly between the mild OSAS group and the control group (p > 0.05). However, as the severity of OSAS increased, the PSVs and EDVs of the OA and CRA were also affected (p < 0.05). CONCLUSIONS: Color Doppler sonographic measurements of blood flow parameters in the orbital vessels may differ significantly between patients with OSAS and those without the syndrome. Therefore, OSAS should be considered in addition to other conditions when interpreting the results of color Doppler sonography of the extraocular orbital vessels if the clinical history points toward such a diagnosis.     

高血压病患者颈动脉改变的彩色多普勒超声特点

目的　探讨高血压病患者颈动脉彩色多普勒变化特点。方法　应用彩色多普勒超声仪对比分析 96例高血压患者和 5 0例正常人双侧颈动脉形态学改变和血流动力学变化。结果　 ( 1)高血压组颈动脉壁增厚 ,斑块检出率明显高于正常人组 ,两组对比有显著性意义 (P <0 .0 5 )。 ( 2 )高血压组收缩期峰值流速 (SPV )、舒张期末流速 (EDV)较正常人组降低 ,血流动力学变化以流速减慢为主。 ( 3)颈动脉血管病变彩色多普勒多有相应特征性变化。结论　彩色多普勒超声能直观、准确、实时反映颈动脉硬化程度。     

彩色多普勒血流显像对青光眼血流动力学研究

本文用美国Ａｃｕｓｏｎ－１２８ＸＰ彩色多普勒检测２４例原发开角青光眼（ＰＯＡＧ）、２７例低压青光眼（ＬＴＧ）及２０例正常人的眼动脉、视网膜中央动脉及睫状后短动脉的血流参数，测定收缩期血流峰值速度（Ｖｍａｘ）、舒张末期血流速度（Ｖｍｉｎ）平均血流速度（Ｖｍｅａｎ）及阻力指数（ＲＩ）、同时测血压及眼压。结果显示，ＰＯＡＧ和ＬＴＧ患者视网膜中央动脉的Ｖｍａｘ、Ｖｍｅａｎ及睫状后短动脉的Ｖｍａｘ、Ｖｍｉｎ、Ｖｍｅａｎ均显著降低，与对照组有显著差异（Ｐ＜０．０５）；而ＰＯＡＧ与ＬＴＧ两组间差异无显著性（Ｐ＞０．０５）。眼动脉的４个血流参数，ＰＯＡＧ、ＬＴＧ与对照组均无显著差异（Ｐ＞０．０５）；收缩压、舒张压三组间亦无显著差异（Ｐ＞０．０５）；而ＰＯＡＧ患者的眼压均值显著高于ＬＴＧ及对照组（Ｐ＜０．０１）。本文结果提示，ＰＯＡＧ和ＬＴＧ患者视网膜中央动脉、睫状后短动脉均存在血流动力学异常。使视盘的血液供应不良，从而导致结构和功能改变。     

超声用于椎动脉发育异常的检测

目的 探讨高频彩色多普勒超声检测椎动脉先天性发育异常的价值。方法 对77例临床可疑为椎．基底动脉供血不足的病人用高频超声观测椎动脉管腔结构、血管走行、血流动力学等变化。结果 在可疑椎．基底动脉供血不足的病人中，椎动脉先天性发育异常率为31％，其中，一侧椎动脉先天性狭窄率为27％，3例为椎动脉穿人颈椎横突孔的位置异常，1例椎动脉颈段呈C型弯曲。结论 高频超声能清晰显示椎动脉颈段及颈椎横突孔之间的椎骨段，由此能判断椎动脉颅外段是否存在先天性发育异常，可做为头晕病人的常规检测项目。