Left Coronary Artery Fistula Identified by Color Doppler Flow Imaging

ＬｅｆｔＣｏｒｏｎａｒｙＡｒｔｅｒｙＦｉｓｔｕｌａＩｄｅｎｔｉｆｉｅｄｂｙＣｏｌｏｒＤｏｐｐｌｅｒＦｌｏｗＩｍａｇｉｎｇＹＡＮＧＹａ（杨娅）；ＬＩＺｈｉ－ａｎ（李治安）；ＷＡＮＧＸｉｎ－ｆａｎｇ（王新房）；ＤＥＮＧＹｏｕ－ｂｉｎ（邓又兵）（Ｄｅｐａｒ...     

Real-time Three-Dimensional Color Doppler Flow Imaging： An Improved Technique for Quantitative Analysis of Aortic Regurgitation

The recently introduced real-time three-dimensional color Doppler flow imaging （RT-3D CDFI） technique provides a quick and accurate calculation of regurgitant jet volume （RJV） and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction （RJF） in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes （LVEDV）, end-systolic volumes （LVESV） and RJV, and then RJF could be calculated. The regurgitant volume （RV） and regurgitant fraction （RF） calculated by two-dimensional pulsed Doppler （2D-PD） method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements （r= 0.93, Y=0.89X＋ 3.9, SEE= 8.6 mL, P〈0.001 ）; the mean （SD） difference between the two methods was - 1.5 （9.8） mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method （r=0.88, Y=0.71X＋ 14.8, SEE= 6.4 %, P〈0. 001）; the mean （SD） difference between the two methods was -1.2 （7.9） %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.     

Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment

Objective To evaluate endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound as a predicator of endometrial receptivity in women undergoing IVF treatment. Methods A total of 119 infertile patients undergoing the first IVF/ICSI-ET cycle were recruited. Three groups were divided according to a color Doppler ultrasound exami- nation performed on the day of hCG injection. Group A, endometrial and subendometrial blood flows were 2 branches and below; group B, endometrial and subendometrial blood flows were between 3 and 4 branches; group C, endometrial and subendometrial blood flows were 5 branches and above. Patients were transferred 1-3 embryos each. Demographic data, ovarian responses, endometrial thickness, PI, RI, development of embryo and IVF result among groups were compared. Results Demographic data, ovarian responses, endometrial thickness, PI, RI and development of embryo among groups have no significant difference. The pregnancy rate of group A was significantly lower than that of group B (P<0.05) and group C (P<0.01). The implantation rate of group A was significantly lower than than of group C (P<0.01). There was no significant difference of the rate of pregnancy and implantation between group B and group C (P>0.05). Conclusion Endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound is a good predicator of pregnancy during IVF treatment. A good endometrial and subendometrial blood flows is benefit for the result of IVF.     

Hemodynamic Changes on Color Doppler Flow Imaging and Intravenous Contrast-enhanced Ultrasound for Assessing Transplanted Liver and Early Diagnosis of Complications

The value of color Doppler flow imaging （CDFI） and intravenous contrast-enhanced ultrasound （CEUS） for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation （OLT） underwent CDFI. The following parameters were measured： peak systolic velocity （PS）, resistance index （RI） and Doppler perfusion index （DPI） of the hepatic artery （HA）, time average velocity （TAV） of portal vein （PV） and velocity of hepatic vein （HV） in different stages postoperation, And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls, The results showed that： （1） In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls （P〈0.05）, PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls （P〈0.05）; （2） When the hepatic artery thrombosis （HAT） occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; （3） While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; （4） The incidence of biliary complications in liver transplantation was increased when DPI was reduced; （5） Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; （6） In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.     

Value of Acceleration Flow in the Left Anterior Descending Coronary Artery for the Detection of Coronary Artery Stenosis by Transthoracic Coronary Color Doppler Echocardiography

Transthoracic color Doppler echocardiographyhas been widely used to measure the coronary ar-tery flowvelocity reserve[1].It is useful to providei mportant informationfor diagnosis of coronary ar-tery disease and assessment of curative effect afterpercutaneous coronary artery intervention.Butthis evaluats onlythe effect of the stenosis on coro-nary artery flow velocity reserve during maxi malhyperemia reaction.Hemodynamics demonstratesthat localized flow acceleration is present at thestenotic s…     

Assessment of Coronary Flow Velocity Reserve by Noninvasive Transthoracic Doppler Echocardiography in Patients with Angiographically Normal Coronary Arteries

Angiographically normal coronary arteries cannot represent“really”normal coronary arteries.The early stages of atherosclerosis and functionalabnormalities may persistent in patients with an-giographically normal coronary arteries.Intravas-cular ultrasound(IVUS)and intracoronaryDoppler flow wire technique(ICD)provide mor-phologic andfunctional information on coronary ar-teries.Studies have shown that IVUS demon-strates atherosclerostic plaques which remain an-giographically undeteted[1].…     

Study on the Regulatory Effect of Electro-acupuncture on Hegu Point （LI4） in Cerebral Response with Functional Magnetic Resonance Imaging

Objective To study, through blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI), the cerebral activated areas evoked by electro-acupuncturing (EA) the right Hegu point (LI4) or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods EA was applied at volunteers’ right LI4 (of 9 subjects in the LI4 group) and facial non-acupoint points (of 5 subjects in the control group), and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm³ used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients’ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group (P<0.01). In the LI4 group, the areas which showed signal activation were: midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were: bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were: bilateral frontal lobe, postcentral gyrus, Reil’s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect’s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research. Supported by the National Natural Science Foundation (No. 90209031)     

Effect of Acupuncturing Houxi（S13）and Shenmen（HT7）in Trealing Cerebral Traumatio Dementia

ＥｆｆｅｃｔｏｆＡｃｕｐｕｎｃｔｕｒｉｎｇＨｏｕｘｉ（Ｓ１３）ａｎｄＳｈｅｎｍｅｎ（ＨＴ７）ｉｎＴｒｅａｌｉｎｇＣｅｒｅｂｒａｌＴｒａｕｍａｔｉｏＤｅｍｅｎｔｉａＺＨＡＮＧＡｎ－ｒｅｎ（张安仁）；ＰＡｎＺｈｉ－ｗｅｉ（潘志伟）；ＬＵＯＦｅｉ（罗绯）ａ...     

Effect of Shenmai Injection(参麦注射液)on Ventricular Diastolic Function in Patients with Chronic Heart Failure:An Assessment by Tissue Doppler Imaging

<正>Objective:To assess the effect of Shenmai Injection(参麦注射液,SMI) on left ventricular diastolic function(LVDF) in patients with chronic heart failure(CHF) by tissue Doppler imaging(TDI).Methods:Sixty-four CHF patients were randomly assigned to two groups,the observation group and the control group.Basic treatment including polarized liquid therapy was given to all the patients.In addition,SMI was given to patients of the observation group.The treatment duration was 14 days.TDI was performed in all the patients 3 days prior to the initiation of the treatment and one week after the medication to measure the average movement velocity of the mitral ring of the left ventricle at the early systolic stage and late diastolic stage(Ea and Aa);the outcomes were compared with the corresponding parameters obtained from blood flow Doppler echocardiography, namely,the velocity of the E-wave(E) and A-wave(A).Results:After treatment,Ea and Ea/Aa increased and Aa decreased significantly in the observation group(P0.05).In the control group,although some improvement was seen,there was no statistically significant change(P0.05).No statistical significance was shown between groups in these parameters after treatment.Conclusion:TDI assessment shows that SMI could effectively improve the LVDF in CHF patients.     

颈动脉粥样硬化的二维及彩色多普勒超声诊断

目的探讨二维及彩色多普勒超声在颈动脉粥样硬化病变中的诊断价值.方法对68例高血压、糖尿病、冠心病、脑梗死等血管疾病的患者进行双侧颈动脉的二维及彩色多普勒超声检查,观察颈动脉内径、内膜、管腔内情况,并进行血流动力学检测.结果其中49例有内膜、斑块等图像特征和血流动力学改变,反映出不同程度颈动脉粥样硬化及狭窄情况.结论超声对诊断颈动脉粥样硬化有一定临床实用价值.     

健康足月新生儿脑血流动力学研究

探讨健康足月新生儿的脑血流动力学改变。方法采用经颅多普勒超声检测健康足月新生儿的脑底动脉。结果发现年龄的不同对多普勒参数可产生明显影响。在新生儿期，血流速呈线性增加（Ｐ＜０．０１），以收缩期峰流速（Ｖｓ）与年龄的相关性最强，其次为平均流速（Ｖｍ）和舒张期末流速（Ｖｄ）。血流速大脑中动脉（ＭＣＡ）＞颈内动脉（ＩＣＡ）＞大脑前动脉（ＡＣＡ）。脉动指数（ＰＩ）、阻力指数（ＲＩ）、ＳＤ参数增高反映了新生儿脑血管阻力较高。出生体重轻重、妊娠周数多少与多普勒参数无关（Ｐ＞０．０５）。结论本研究为新生儿脑血流的生理或病理状态变化提供了一种无创性检测方法     

彩色多普勒超声对高强度聚焦超声治疗子宫肌瘤的疗效观察

目的探讨彩色多普勒超声显像(CDFI)对高强度聚焦超声(HIFU)治疗子宫肌瘤的近期疗效及其实用性。方法选择我院自2008年4月至2011年10月不愿意行手术切除子宫肌瘤的育龄期已生育患者182例,应用FEP-BYO2型高强度超声聚焦治疗机进行治疗,治疗后应用CDFI观察比较治疗前后瘤体大小、回声、血流动力学等不同的改变。结果 182例子宫肌瘤HIFU治疗后3个月CDFI随访统计,瘤体明显缩小者130例(71.4%),瘤体内回声明显增强改变158例(86.8%),血流信号消失或明显减少者164例(90.1%),月经期经量明显减少,临床症状明显改善者143例(78.6%)。HIFU治疗子宫肌瘤总有效率为86.8%(158/182)。结论高强度超声聚焦是治疗子宫肌瘤的安全、有效方法,CDFI可用于HIFU疗效的观察及评价。     

彩色多普勒超声对婴儿外科性黄疸的诊断价值

目的在婴儿期有多种引起黄疸的肝胆外科疾病,本研究通过术前对胆道闭锁、先天性胆总管囊肿等疾病声像图形态特点及血供的观察,探讨彩色多普勒超声显像在婴儿外科性黄疸鉴别诊断中的应用价值.方法二维超声观察肝脏、胆囊及胆管的形态大小,彩色多普勒超声观察门静脉及肝动脉的血流并鉴别肝动脉及胆管结构.结果手术治疗胆道闭锁20例,超声术前诊断18例;先天性胆总管囊肿16例,超声术前诊断16例.胆道闭锁术前超声显示肝脏肿大,胆囊细小且壁增厚,肝门部三角形高回声块,门静脉流速减慢,肝动脉流速增快,阻力指数增大.先天性胆总管囊肿超声显示胆总管部位囊性包块.结论彩色多普勒超声对婴儿外科性黄疸常见病因的早期诊断、鉴别诊断与指导治疗均有重要的应用价值.     

彩色多普勒血流显像对血管内血栓和瘤栓的鉴别诊断

应用彩色多普勒血流显像对55例血管内栓塞物性质进行鉴别诊断。结果表明：31例血栓内均无血流信号。而24例瘤栓中有11例癌栓内测及动脉血流信号，阻力指数0．61±0．12。5例同时可测及静脉血流信号。12例瘤栓旁可见异常丰富动脉血流信号，瘤栓范围越大血流越丰富。栓塞物性质的鉴别有利于寻找原发病灶及预后评价。     

胎儿肾,脑动脉的彩色多普勒监测及其临床意义

作者利用双功能彩色多普勒技术对５２例正常中、晚孕２２例高危妊娠胎儿大脑中动脉及肾动脉血流频谱进行观察及分析，结果表明随着胎龄的增大，胎儿脑、肾动脉收缩期峰值血流速度明显加快，脑动脉血流阻力指数（ＲＩ）及搏动指数（ＰＩ）略减低，肾动脉ＲＩ及ＰＩ有增加趋势。肾、脑动脉ＲＩ及ＰＩ的比值于中晚孕无明显变化，妊高症及宫内发育迟缓者ＲＩ’及ＰＩ’较正常晚孕组明显增高，以双功能彩色多普勒监测胎儿肾动脉及大脑中动     

乳腺癌彩色多普勒血流特征的分析

目的：观察、分析乳腺癌彩色多普勒血流（CDF）分布特征及频谱形态,以提高超声检查对乳腺恶性肿块诊断的准确率。方法：对40例乳腺癌及47例乳腺纤维腺瘤患者进行CDF检查,重点观察肿块的血管分布形态及其频谱特征。结果：①乳腺癌肿块的血流检出率100.0％,其中Ⅱ、Ⅲ级血流为87.5％,穿人性动脉血管显示率67.5％。乳腺纤维腺瘤的血流检出率85.1％,其中0、I级血流为65.9％,穿人性血管显示率4.3％。②乳腺癌的CDF频谱形态表现为：收缩期峰值前移,其上升支速度快,下降支较缓慢,舒张末期血流信号少或无血流。乳腺纤维腺瘤的CDF频谱形态为：收缩期上升支及下降支均较缓慢,峰值流速低,舒张末期血流信号较丰富。结论：穿人性动脉血管及其多普勒频谱形态变化是诊断乳腺癌的重要参考指标。     

彩色多普勒技术对肝移植大鼠急性排斥反应监测的研究

[目的]应用彩色多普勒血流成像（color doppler flowimaging,CDFI）技术观察原位肝移植（orthotopic liver trans-plantationo,OLT）后大鼠肝脏的血流情况,并与病理损害对照,探讨CDFI与大鼠肝移植后排斥反应的可行性。[方法]正常组：Wistar大鼠8只。建立OLT模型,将动物分为4组,每组SD大鼠、Wistar大鼠各8只。对照组：未予药物干预;CsA组：给予环孢素A30 mg.kg-1.d-1,胃内给药;SIN组：给予青藤碱40 mg.kg-1.d-1,胃内给药;CsA＋SIN组：给予青藤碱40 mg.kg-1.d-1＋环孢素A15 mg.kg-1.d-1,胃内给药。术后4天、10天CDFI测量肝脏门静脉、下腔静脉的血流速度,术后10天处死大鼠取肝脏组织行病理检查。[结果]门静脉血流速度：术后4天对照组明显低于各手术组,CsA组与SIN＋CsA组明显增快,SIN组轻度增快。术后10天血流速度普遍下降（P〈0.05）。CsA组与SIN＋CsA组仍快于正常组（P〈0.05）,SIN组与正常组差异无显著性意义（P〉0.05）。动物模型组内肝脏病理损害与门静脉血流速度呈负相关关系（r=-0.776,P〈0.01）。[结论]彩色多普勒技术可作为监测大鼠肝移植术后是否有排斥反应发生的一种有效手段,门静脉血流速度的降低提示移植肝脏可能发生了排斥反应。     

肾盂癌的超声诊断

本文总结分析了经手术病理证实的２２例肾盂癌的超声表现，结果表明肾盂癌的声像图分两种类型，即低回声型（占８１．８２％）和强回声型（占１８．１８％），其回声水平与肿瘤内出血、坏死程度密切相关。同时，分析了其中５例肾盂癌彩色多普勒血流显像（简称彩超）的表现，发现肾盂癌病灶内缺乏高速动脉血流信号，而此类血流信号通常可在肾细胞癌中检出，因此认为彩超对鉴别从部位上难以区分的肾细胞癌与肾盂癌有较大帮助。     

彩色多普勒超声评价颈总动脉狭窄方式对血液动力学的影响

目的：了解颈总动脉不同形式的狭窄对其血液动力学和病变远端的颈内动脉阻力指数(RI)的影响，为判定脑组织的血流状态提供客观依据。方法：选择颈总动脉同心团型狭窄I组56条和偏心型狭窄Ⅱ组60条，彩色多普勒超声制定颈总动脉狭窄处收缩期最大流速(PSV)、舒张末期血流速度(EDV)和远端的颈内动脉的阻力指数(RI)。结果：颈总动脉狭窄程度80％～90％范围时，Ⅱ组的PSV较I组增高；颈总动脉狭窄程度＞80％时，Ⅱ组的EDV较I组明显减低，Ⅱ组颈内动脉颅外段的RI值比I组增大。结论：颈总动脉偏心型狭窄对其血液动力学的影响大，对保证脑组织正常血流量有不利的影响。