双功能超声在诊断下肢动脉硬化性闭塞症中的应用(附78例分析)

目的：探讨双功能超声在诊断下肢动脉硬化症中的应用价值。方法：回顾性地分析了78例下肢动脉硬化性栓塞病例的二维超声图像及彩色多普勒血流显像改变。结果：二维超声图像上表现为病变血管内中膜呈不规则增厚，局部呈强回声斑显示，并向血管腔内突起，血管腔内径呈不规则狭窄，病变段血管腔内可见实性光团充填，彩色多普勒血流显像显示血管腔内未见血流信号显示。结论：双功能超声对下肢动脉硬化闭塞症的诊断具有很高的灵敏性和准确性。     

超高频彩色多普勒超声在诊断血栓性闭塞性脉管炎中的临床应用价值

目的探讨超高频彩色多普勒超声在四肢动脉血栓性闭塞性脉管炎诊断中的应用价值。方法209例中共检出受累血管405条,受累动脉血管均行超高频探头进行二维,彩色多普勒血流显像及脉冲多普勒超声检查,记录病变血管前、后段血管收缩期最大流速。21例行动脉血管CTA检查。结果超高频彩色多普勒超声能够清晰的显示受累动脉血管壁改变,血管腔内血栓形成、血栓再管化的程度及正常血管与病变血管移行区。结论超高频彩色多普勒超声在诊断血栓性闭塞性脉管炎中具有极高的灵敏性和特异性,是诊断血栓性闭塞性脉管炎的首选办法。     

彩色双功能超声在诊断颈内动脉粥样硬化狭窄中的临床应用

目的:探讨彩色双功能超声在颈内动脉粥样硬化狭窄中的临床应用价值。方法:对58例由于动脉粥样硬化导致颈内动脉狭窄的患者进行二维超声及彩色多普勒血流显像检查,并利用脉冲多普勒对动脉血管狭窄处及狭窄前的血流信号进行测量,同时测量颈总动脉的血流速度。结果:通过测量颈内动脉狭窄处收缩期峰值流速和舒张末期血流速度、颈总动脉收缩期峰值流速和舒张末期血流速度,将二者血流速度相比较并进行分析,同时与彩色多普勒血流显像通过狭窄处血管面积的变化所测的狭窄程度相对照,共检出62支颈内动脉狭窄,其中5支颈内动脉血管腔内血栓形成。二者相结合诊断颈内动脉狭窄的灵敏性和准确性分别为96%和94%。结论:彩色双功能超声在颈内动脉狭窄的诊断中具有重要的临床价值。     

彩色双功能超声在诊断巨细胞动脉炎中的应用价值

目的:探讨双功能彩色超声检查在诊断巨细胞动脉炎中的临床应用价值。方法:自2001年5月~2004年10月间我室共检查了27例临床疑似巨细胞动脉炎病例,其中男性19例,女性8例,平均年龄为66.4岁。其中15例经彩色双功能超声诊断为颞浅动脉炎,所有超声确诊病例均进行颞动脉活检,CT强化扫描检查并行颞动脉血管三维重建,双功能彩色超声的高频线阵探头对双侧颞动脉进行检查主要观察颞浅动脉在形态学上的特征性改变,巨细胞动脉炎的超声形态学特征性改变为:在彩色多普勒血流显像检查时颞动脉血管腔周围有一低回声“晕”,血流信号呈充盈缺损样改变,血管腔狭窄或闭塞;或者血管内膜呈不规则增厚,回声增强,血管腔不规则狭窄,类似于动脉硬化斑块形成。结果:彩色双功能超声诊断阳性病例为15例,临床病理活检证实12例,3例为假阳性,超声诊断准确率为80%。结论:在诊断巨细胞动脉炎中高分辨力彩色双功能超声的诊断准确率高,可以替代颞动脉病理活检。     

多发性大动脉炎外周血管病变的超声诊断

目的:探讨多发性大动脉炎外周血管病变的超声表现,提高对本病的认识.方法:采用美国泰索尼彩色多普勒超声诊断仪,探头频率10MHz,对9例大动脉炎患者外周血管进行二维及彩色多普勒超声检测.结果:9例大动脉炎患者受累血管分布为头臂动脉7例,其中锁骨下动脉7例,颈总动脉6例,腹主动脉2例,肾动脉2例,混合型2例.表现为病变动脉管壁不规则增厚、管腔狭窄或闭塞.根据狭窄程度不同,彩色多普勒呈高速湍流、低速血流及无血流信号.结论:超声诊断多发性大动脉炎外周血管病变有确切的价值,可作为临床诊断多发性大动脉炎的首选方法.     

糖尿病下肢动脉病变的彩色多普勒超声观察

目的:探讨彩色多普勒超声诊断糖尿病下肢动脉病变的价值。材料和方法:应用彩色多普勒超声对76例糖尿病患者(糖尿病组)和30例正常人(对照组)下肢动脉进行检查,观察血管内径、内膜、有无斑块、管腔狭窄或闭塞及血流动力学改变。结果:76例糖尿病患者中有71例下肢动脉有不同程度的硬化,发生率为93.4%;糖尿病组下肢动脉内径、血流速度较对照组明显减少(P<0.01),以足背动脉最明显,腘动脉次之;糖尿病组下肢血管管腔内膜增厚、硬化斑块、狭窄、闭塞的发生率明显高于对照组(P<0.05),其中股动脉斑块发生率最高,足背动脉狭窄发生率最高,闭塞仅见于足背动脉。结论:彩色多普勒超声可显示下肢动脉病变部位、范围、程度,对诊断糖尿病下肢动脉病变有重要价值。     

联合超声技术在外周动脉血管中的应用价值

目的 探讨联合超声技术在外周动脉血管中的应用价值.方法 对68例外周动脉血管疾病患者分别行二维超声 彩色多普勒血流显像(A组)与二维超声 彩色多普勒血流显像 二维血流显示技术(B组)超声检查.结果 两组技术对外周动脉斑块均有较高的检出率,且B组优于A组.结论 联合超声技术在外周动脉血管疾病诊断中有较高的准确性,可作为临床诊断的首选方法,可为临床提供可靠的检测信息.     

彩色多普勒血流显像对肠系膜上动脉闭塞性疾病的诊断价值

目的探讨彩色多普勒血流显像诊断肠系膜上动脉闭塞性疾病的临床价值。资料与方法回顾20例经血管造影证实的肠系膜上动脉闭塞性病变的彩色多普勒血流表现,分析血流频谱与管腔狭窄程度的关系。结果本组中完全性闭塞3例,均经超声检出;15例重度狭窄中,超声误诊为闭塞1例,其余14例与血管造影结果相符;2例中度狭窄的病变,超声误判为重度。结论彩色多普勒血流显像能准确诊断肠系膜上动脉闭塞性疾病。     

彩色多普勒超声在诊断下肢深静脉血栓形成后继发性动静脉瘘形成中的临床价值

目的探讨彩色多普勒超声血流显像在诊断下肢深静脉血栓形成后深静脉血管腔内多发动静脉瘘形成的临床价值。方法收集下肢深静脉血栓腔内继发性动静脉瘘患者59例,行双侧下肢深静脉彩色多普勒超声检查,对确定的病变位置和范围,测量最大流速,阻力指数。结果本组59例病例中累及髂外静脉者18例,股总静脉15例,股浅静脉12例,腘静脉7例,肌间静脉6例,其中1例发生于浅静脉血管腔内,病变血管血栓再管化率低于10%,血管阻力指数为0.33～0.48。结论下肢深静脉血栓形成后深静脉血管腔内多发动静脉瘘形成在彩色多普勒超声现象中具有特征性表现,是诊断本病的首选影像学检查方法。     

超声血管增强技术在外周血管疾病中的诊断价值

目的评价超声血管增强技术(vascular enhancement technology,VET)在外周病变的临床应用价值。方法对90例外周血管病变的患者(52例颈动脉病变、16例下肢动脉病变及22例下肢深静脉病变)应用超声血管增强技术,显示病变的血管,并与传统二维谐波及彩色多普勒(CDFI)成像相对比。结果常规二维超声检查28例(31.11%)图像不能清晰显示,应用VET技术,86例(95.56%)外周血管病变患者的血管腔、血管壁及病灶(斑块、血栓)更清晰显示,图像质量评分VET高于传统二维超声,为2.91:2.09,(P<0.01)。结论 VET技术可提高能提高血管与周边组织对比分辨力,更清晰显示血管腔、管壁结构及病灶,具有较高的临床应用价值。     

Saccular neck venous aneurysm on color duplex sonography: an analysis of 12 cases

ObjectiveTo discuss the characteristics of saccular neck venous aneurysm on color duplex sonography.MethodsWe retrospectively reviewed 12 cases of saccular neck venous aneurysm confirmed by either venogram or surgical pathology. Clinical information, physical exam of the neck, and characteristics of saccular neck venous aneurysm on color Doppler sonography (CDUS) were analyzed. Diagnosis and differential diagnosis of saccular venous aneurysm on color duplex sonography were discussed.ResultsThe communication between saccular venous aneurysm and related vein was visualized on grayscale imaging in 11 cases (11/12), which was observed in all 12 cases (12/12) on color Doppler image. Spectral Doppler was useful in the demonstration of venous flow in both the communicating vein and venous aneurysm. The documentation of venous flow in both venous aneurismal sac and communicating vein was obviously improved with contrast enhanced ultrasound in one case.ConclusionIt is important to have knowledge of venous aneurysm, an uncommon condition in sonographic practice. Saccular venous aneurysm should be taken into consideration in differential diagnosis when a cystic lesion in the neck appears on color Doppler sonography.     

甲状腺结节的高频超声声像图特点及彩色多普勒血流特征分析

目的 探究甲状腺结节的高频超声声像图特点结合彩色多普勒血流特征,从而鉴别判断甲状腺结节的良恶性.方法 以最终术后病理结果为依据,按良恶性病变的不同,将2017年1月～2018年5月接收的131例甲状腺结节患者分为甲状腺良性结节组和甲状腺恶性结节组两组.甲状腺良性结节组68例,甲状腺恶性结节组63例.均接受高频超声及彩色...     

急性下肢深静脉血栓形成的多普勒超声诊断与手术对照

目的 :探讨常规超声和彩色多普勒超声 (CDFI)对急性下肢深静脉血栓形成 (DVT)诊断的价值。方法 :对 94例急性DVT病例进行了常规超声和CDFI检查并经手术证实。结果 :DVT声像表现为静脉内径增宽 ,腔内实质回声 ,按压静脉未变形 ,静脉瓣固定等 ,彩色多普勒可无血流信号或腔内充盈缺损确诊。本组病例均经手术证实 ,无一误诊。结论 :彩色多普勒与常规超声联合应用为诊断急性DVT的首选方法     

Underassessment of lower extremity deep venous thrombosis using color flow Doppler compared to compression sonography

The aim of this paper is to compare the accuracy of color Doppler to compression sonography in the diagnosis of lower extremity deep vein thrombosis. Longitudinal color flow imaging was performed in 60 lower extremities in patients with clinically suspected deep venous thrombosis (DVT). The study was then repeated by a blinded examiner using transverse compression sonography. The results were then correlated. Thirty-five examinations were negative by both color flow and compression methods. Twenty thrombi were diagnosed on compression sonography, while only 13 were diagnosed by the color flow method. Thirty-five percent of thrombi were missed using color flow imaging alone. We conclude that compression sonography should remain an integral part of the assessment of lower extremity DVT, as a significant number of thrombi might be overlooked using longitudinal color flow imaging alone. This is especially true in non-occlusive thrombi that are adherent to the vessel wall.     

Colour doppler flow imaging of the carotid arteries

Summary 53 patients with carotid artery atherosclerosis were examined by colour Doppler flow imaging. These results were compared with real time duplex sonography and continuous wave Doppler sonography. In 48 low degree stenoses (<50%) the B-mode showed 36 smooth and 12 ulcerated plaque surfaces. In 24 high degree stenoses (>50%) 10 plaques were smooth and 14 ulcerated. In the low degree stenoses, which exhibited smooth surfaces in B-mode examination, colour flow Doppler showed nine additional cases with turbulences in the area of the stenotic site. This indicates that plaque ulcerations in low degree stenoses are underestimated. In contrast, in nearly all cases with high degree stenoses marked turbulences could be demonstrated by colour Doppler flow imaging independent of the B-mode showing regular or ulcerated plaque surfaces. Additionally, the duplex ultrasound diagnosed a carotid artery occlusion in 11 cases, but the colour coded Doppler was able to assess a remaining blood flow in two out of these 11 cases. Our results suggest that the colour Doppler flow imaging as a noninvasive technique is an advantage in diagnosing plaque ulcerations and it is more precise in diagnosing carotid occlusions than duplex-sonography is.     

椎动脉颅内段及颅外段联合超声检查对椎基底动脉供血不足的诊断价值

目的：探讨椎动脉颅内段及颅外段联合超声检查对椎基底动脉供血不足（VBI）的诊断价值。方法：用经颅彩色双功超声（TCCD）和彩色多普勒血流成像（CDFI）对110例VBI和30例对照组的患者椎动脉形态、结构和血流进行观察分析。结果：TCCD诊断VBI的敏感性89．1％,CDFI诊断VBI敏感性为81．8％,TCCD联合CDFI检查的敏感性92．7％。结论：TCCD联合CDFI检查可系统地了解椎动脉颅内外的供血情况及血管的形态结构,明显的提高对VBI的诊断率,可作为VBI病因诊断、治疗效果观察的客观依据。     

眶内肿瘤的彩色多普勒表现及诊断价值

目的:探讨眶内肿瘤彩色多普勒表现及诊断价值。方法:对经CT或MR检查确诊为眶内肿瘤或占位性病变的病人进行彩色多普勒观察,了解其二维表现及规律、血流及分布情况。结果:98例眶内肿瘤中泪腺癌16例,海绵状血管瘤16例,炎性假瘤11例,脑膜瘤9例,皮样囊肿9例,眶内转移癌8例,神经鞘瘤8例,肉瘤7例,较少见的病14例。根据本组病例观察,完全可以根据所显示的眶内肿瘤的声像图表现、特点及血流情况作出诊断,实时观察血流情况,帮助临床制定手术方案。结论:超声在探测眶内肿瘤方面有较高的诊断价值,尤其在对肿瘤血供的实时观察方面,对临床有很大的帮助,临床可根据需要选择不同的影像检查方式。     

Transrectal ultrasound color Doppler in the evaluation of recurrence of anal canal cancer

OBJECTIVE: aim was to obtain elements for a differential diagnosis between post-radiation fibrosis and residual tumor or local relapse in anal canal cancer through detection of presence/absence of intralesional blood flow. Transrectal ultrasound and color Doppler were compared. METHODS: 43 patients underwent transrectal ultrasound sonography and color Doppler before and after therapy to assess intralesional blood flow and flow pattern (spotty and linear signals). All diagnostic imaging results were compared to histological analysis. Specificity was submitted to statistical analysis using McNemar test. RESULTS: before therapy 34 lesions (79%) showed color signal; no signal in 9 (21%), which were excluded from our analysis. Eighteen of the 34 patients considered, presented complete response to therapy, 14 partial response and two no response. After therapy, signal disappeared in 17 patients (94%); one false-positive (6%) presented spotty signals; 16 of 34 patients presented changed color signal. Color Doppler showed higher specificity than grey scale transrectal ultrasound in the differentiation of fibrosis from tumor. Response was confirmed by histological examination, considered gold standard. McNemar test demonstrated the significance of color Doppler (P < 0.0001). CONCLUSION: color Doppler considerably increases transrectal ultrasound specificity in differentiating tumor relapse from fibrosis in anal canal cancer.     

Budd-Chiari syndrome: value of duplex sonography and colour Doppler imaging for diagnosis and follow-up

This retrospective study was designed to evaluate duplex sonography in the diagnosis and follow-up of patients with Budd-Chiari syndrome. Thirteen patients with clotting disease and histologically proven Budd-Chiari syndrome (3 acute and 10 chronic cases) were examined, using conventional duplex sonography (n=5) or colour-coded duplex sonography (n=8). Results were compared with CT in 6 cases, MRI in 11, coeliac and mesentric angiography in 5, and hepatic wedge venography and cavography in 6. Of 39 hepatic veins examined, 33 had an abnormal appearance on ultrasound studies: endoluminal thrombus, stenosis, dilatation, thick wall echoes. Doppler findings included total obstruction of 8 hepatic veins, reversed flow in 22 hepatic veins and intrahepatic collaterals with continous non-phasic flow in all cases. Duplex sonography showed portal thrombosis (n=1), evidence of portal hypertension (n=8) and inferior vena cava thrombosis (n=2). Nine patients were treated surgically. Patency of portocaval shunts was correctly assessed with colour coded duplex sonography in 8 of 9 patients. We believe that colour Doppler imaging is the procedure of choice for initial diagnosis of Budd-Chiari syndrome. Correspondence to: M. F. Bellin