正常成年人肠系膜下动脉血液动力学的多普勒超声检测

目的：测量正常成年人肠系膜下动脉（ＩＭＡ）的血流参数值。方法：应用多普勒超声测量１５０例健康成年人ＩＭＡ的多种血流参数。结果：ＩＭＡ的搏动指数（ＰＩ）、阻力指数（ＲＩ）、血管内径（Ｄ）在年龄、性别上均无统计学差异;而ＩＭＡ的最大流速（Ｖｍａｘ）、平均流速（Ｖｍｅａｎ）、血流量（Ｑ）在年龄、性别上有统计学差异。结论：提出正常人ＩＭＡ的血流参数值。     

乳内动脉的超声检查

目的：对正常人群的乳内动脉（ＩＭＡ）作彩色多普勒超声检查,并进行了血流动力学分析,旨在为临床提供安全可靠的检查方法。方法：１８４名正常人分为男女两组,每组再分三个年龄段。对１８４人的３６８条ＩＭＡ作了彩色多普勒超声检查。测量每条ＩＭＡ的收缩期峰值与舒张末期流速之比（Ｓ／Ｄ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）,计算舒张期流速时间积分分数（ＤＶＴＩＦ）,并作了统计学处理。结果：左右两侧各项测值没有显著性差异;男女两组间虽然Ｓ／Ｄ、ＰＩ、ＲＩ有显著性差异,但ＤＶＴＩＦ并无显著性差异;老年组（６１～７０岁）与中年组（４１～５０岁及５１～６０岁）间各项测值均有显著性差异。结论：在ＩＭＡ－冠状动脉搭桥术前后,彩色多普勒超声检查是测量ＩＭＡ血流动力学可靠的无创方法。     

彩色多普勒超声检查在正常成人肠系膜上动脉血流参数测定中的应用

目的测量正常人肠系膜上动脉（SMA）的血流参数。方法应用彩色多普勒血流显像测量160例健康人SMA的血流参数。结果SMA直径（D）、收缩期峰值流速（PSV）、平均流速（Vmean）、阻力指数（RI）、搏动指数（PI）男女性别之间、年龄组之间差异无显著性。结论确定了正常人SMA血流参数的正常值范围。     

彩色多普勒测定新生儿颅内动脉血流正常值100例报告

目的： 研究新生儿脑血流的血流动力学参数。方法： 应用彩色多普勒检测正常新生儿脑动脉血流变化的规律性。结果： 同名双侧大脑动脉血流的收缩期峰流速 （ＰＳ）、舒张末流速 （ＥＤ）、阻力指数 （ＲＩ）、搏动指数（ＰＩ） 经统计学处理, 无显著性差异Ｐ＞ ０．０５。结论： 提出了国人正常新生儿ＡＣＡ, Ｍ ＣＡ, ＰＣＡ 血流参数的正常值范围。     

超声心动图定量诊断二尖瓣狭窄瓣口面积的临床研究

目的： 探讨主动脉血流连续性方程法 （ＡＦＣＥ）、二维超声法 （２ＤＥ）、压差减半时间法 （ＰＨＴ）、二尖瓣血流连续性方程法 （Ｍ ＦＣＥ）、近端等速表面积法 （ＰＩＳＡ） 及近端球缺表面积法 （ＰＳＳＡ） 测量二尖瓣狭窄瓣口面积（Ｍ ＶＡ） 的准确性。方法： ２０ 例接受瓣膜置换术的二尖瓣狭窄患者， 术前利用上述６ 种方法测量其Ｍ ＶＡ， 与术中直接测值 （ａＭ ＶＡ） 进行对比。结果： （１） 除ＡＦＣＥ 法外， 其余５ 种方法均与ａＭ ＶＡ 高度相关， 又以 ２ＤＥ 相关最佳；（２） ２ＤＥ 法高估了ａＭ ＶＡ 测值，而其他５ 种方法与ａＭ ＶＡ 无显著差异。结论： 在Ｍ Ｓ患者Ｍ ＶＡ 的测量中，２ＤＥ、ＰＨＴ和ＰＳＳＡ 法具有较高的临床应用价值； 角度校正系数是影响ＰＩＳＡ 法准确性的关键。     

超声心动图测量二尖瓣狭窄瓣口面积六种方法的对比研究

目的：对比研究主动脉血流连续性方程法（ＡＦＣＥ）、二维超声法（２ＤＥ）、压差减半时间法（ＰＨＴ）、二尖瓣血流连续性方程法（ＭＦＣＥ）、近端等速表面积法（ＰＩＳＡ）及我们晚近提出的近端球缺表面积法（ＰＳＳＡ）测量二尖瓣狭窄瓣口面积（ＭＶＡ）的相对准确性。方法：在２１例单纯二尖瓣狭窄患者,利用上述６种方法测量ＭＶＡ,以ＡＦＣＥ测值为标准进行对比研究。结果：（１）后５种方法与ＡＦＣＥ测值均高度相关;（２）２ＤＥ和ＰＩＳＡ两种方法显著高估了ＡＦＣＥ测值,而ＰＳＳＡ、ＰＨＴ、ＭＦＣＥ三种方法与ＡＦＣＥ的测值无显著差异。结论：在单纯二尖瓣狭窄患者ＭＶＡ的测量中,ＡＦＣＥ、ＰＨＴ、ＭＦＣＥ和ＰＳＳＡ有较高准确性,又以ＰＳＳＡ法最为准确实用。     

冠状动脉搭桥术前后乳内动脉的超声检查

目的：研究冠状动脉搭桥术前后乳内动脉（ＩＭＡ）血流动力学的改变,为临床提供安全可靠的检查方法。方法：５０名ＩＭＡ－冠状动脉前降支（ＬＡＤ）搭桥术的患者于手术前后作了ＩＭＡ的超声检查。测量ＩＭＡ的收缩期峰值与舒张末期流速之比（Ｓ／Ｄ）,搏动指数（ＰＩ）,阻力指数（ＲＩ）,计算舒张期流速时间积分分数（ＤＶＴＩＦ）。将与ＬＡＤ吻合的ＩＭＡ手术前后的测值进行比较,并将术后两侧ＩＭＡ的测值进行比较,作统计学处理。结果：手术前后转流侧ＩＭＡ测值比较,血流动力学发生改变。Ｓ／Ｄ,ＰＩ,ＲＩ及ＤＶＴＩＦ均有显著性差异（Ｐ＜０．０１）。手术后转流侧ＩＭＡ与对侧比较,以上各项血流动力学测值同样有非常显著性差异（Ｐ＜０．０１）。ＩＭＡ的血流由术前的收缩期优势型转变为术后的舒张期优势。结论：超声检查在术前对ＩＭＡ可进行筛选,术后是随访转流血流通畅性可靠的无创方法。     

应用多普勒超声对肝转移癌及肝硬化患者的血流动力学研究

目的：多普勒超声（Ｄ－ＵＳ）测定多普勒血流灌注指数（ＤＰＩ）,门脉充血指数（ＰＣＩ）和阻力比（ＲＲ）等血流参数在肝转移癌和肝硬化时的变化,用以评价 血流参数对转移癌和肝硬化的诊断价值。材料与方法：１５例肝硬化,１５例肝转移癌和１８例对照组在禁食１２小时后,分别测其肝总动脉（ＣＨＡ）,肠纱膜上动脉（ＳＭＡ）和门静脉（ＰＶ）的有关血流参数,并计算ＤＰＩ,ＰＣＩ,ＲＲ等。结果：（地）肝转移癌组的ＤＰＩ显     

肝硬化腹腔动脉血流动力学改变的超声多普勒研究

本文应用彩色多普勒探测４２例肝硬化患者及１５例正常人脾动脉（ＳＡ）、肠系膜上动脉（ＳＭＡ）血流参数，研究肝硬化腹腔动脉血流动力学变化与上消化道出血及腹水的关系。结果表明肝硬化食管静脉曲张上消化道出血患者脾动脉阻力指数（ＳＡＲＩ）较无出血组及对照组明显增高，提示ＳＡＲＩ与肝硬化门脉高压密切相关，可作为预测食管静脉曲张上消化道出血的一项无创性新指标；此外大量腹水的出现有可能减低门脉压力，减少食管静脉曲张上消化道出血的发生     

彩色多普勒和三维能量造影诊断肠系膜上动脉综合症

目的： 探讨新型彩色超声多普勒在肠系膜上动脉综合征 （ＳＭ ＡＳ） 中的应用。方法： 对８ 例ＳＭ ＡＳ患者 （ＳＭ 组） １５ 例正常人 （ＮＳ组） 及 ２３ 例经常腹胀不适, 饱食后加重, 多项检查未发现器质性病变而疑为ＳＭ ＡＳ患者 （ＳＳ组） 进行了三维血流能量成像及彩色多普勒研究。结果： １三维能量超声造影技术在三组资料中均能清晰显示肠系膜上动脉 （ＳＭ Ａ） 与腹主动脉 （ＡＯ） 之间的夹角及角内左肾静脉 （ＬＫＶ） 的情况, 显示率 １００％ 。２ＳＭ 组１００％ （８／８） 夹角小于１９５°, 最小者 ２°, 最大者 １８°。ＮＳ组 ６７％ （１／１５） 小于 １９５°, 最小者 １７°, 最大者 １３４°（Ｐ＜ ００１）, 平均５４９３°。３ＳＭ 组 １００％ （８／８） 存在角内ＬＫＶ 明显受压且血流呈高速湍流状态, ＮＳ组 ２７％ （４／１５） 仅存在轻度受压, ６７％ （１／１５） 角内ＬＫＶ 呈高速湍流状态（Ｐ＜ ００１）。４ＳＳ组中２１７％ （５／２３） 基本符合ＳＭ ＡＳ诊断, 从而为这一类患者提供了新的病因线索。５ＳＭ 组中２ 例为孪生兄弟, 并发症发生率为 ５０％ 。结论： ＳＭ ＡＳ并不少见, 只是有些不易被发现, 有些     

肝癌手术前后肠系膜上动脉血流分析

目的 探讨肝癌手术治疗前后肠系膜上动脉（ＳＭＡ）血流动力学改变。方法 用彩色多普勒超声对６２例肝癌病人手术治疗前后肠系膜上动脉血流检测,分析收缩期峰值流速（ＶＰ）、舒张期最低流速（Ｖｍｉｎ）及阻力指数（ＲＩ）的改变。结果 肝癌病人手术前后肠系膜上动脉ＶＰ、Ｖｍｉｎ有明显改变（Ｐ〈０．０５）,ＲＩ值变化无统计这意义。结论 肝癌手术切除后一周内ＳＭＡ血流ＶＰ及Ｖｍｉｎ均呈代偿性增加。     

Crohn disease activity evaluated by Doppler ultrasonography of the superior mesenteric artery and the affected small-bowel segments.

OBJECTIVE: To reveal the disease activity in Crohn disease by gray scale and Doppler ultrasonography of the superior mesenteric artery (SMA) and the affected bowel segments. METHODS: Twenty-six patients (12 with active and 14 with inactive disease according to the Crohn disease activity index) were prospectively evaluated with gray scale and Doppler ultrasonography. The control group included 10 healthy subjects. In the SMA evaluation, anteroposterior diameter, resistive index (RI), and flow volume were measured. In the affected small-bowel segments, wall thickness, mural vascularity, RI, and extraintestinal findings were evaluated. RESULTS: Differences between the active and inactive groups but not between the inactive and control groups were statistically significant for mean SMA diameter, RI, and flow volume (P = .019; P < .001; and P < .001, respectively). Superior mesenteric artery flow volume values were higher than 500 mL/min in the active group except 2 patients (sensitivity, 83%; specificity, 100%). Increased gut wall thickness and vascularity were highly significant for patients with active disease (P < .001). The mean SMA RI value of the active group was significantly lower (P < .001). Doppler measures of vascularity were similarly affected in the SMA and the bowel wall in the active subgroup. In 10 patients with active disease and higher SMA flow volume (>500 mL/min), the affected small-bowel segments also had increased wall thickness and vascularity. CONCLUSION: Evaluation of the SMA and the affected small-bowel segments together by gray scale and Doppler ultrasonography is a reliable quantitative method for determining Crohn disease activity. Findings obtained from both the SMA and the affected small-bowel segments showed parallel results about the disease activity.     

Quantitative measurement of abdominal arterial blood flow using image-directed Doppler ultrasonography: Superior mesenteric,splenic, and common hepatic arterial blood flow in normal adults

To measure volume blood flow quantitatively in human abdominal arteries, we used an ultrasonic image-directed Doppler system and electromagnetic flow-meter to first measure volume flow in canine arteries. In dogs, there was a strong linear correlation (R = 0.98) between the product of the time average of the maximum blood flow velocity and the average cross-sectional area and the volume blood flow measured by an electromagnetic flow-meter. These results enabled measurement of volume blood flow in the human superior mesenteric (SMA), splenic (SPA), and common hepatic (CHA) arteries from the abdominal wall. Comparison of pulsatility index values indicated a larger vascular resistance in the SMA than in the SPA or CHA.     

Effect of fat digestion on superior mesenteric artery blood flow in humans

BACKGROUND AND AIM: Intraluminal nutrients stimulate superior mesenteric artery (SMA) blood flow. Of the macronutrients, especially fat affects the magnitude of the SMA blood flow response to a meal. Little is known however on the influence of fat hydrolysis on SMA flow. METHODS: We compared in eight healthy volunteers the SMA flow response (Doppler ultrasonography) to continuous intraduodenal fat perfusion (LCT, 240 kCal h(-1)) during conditions with normal hydrolysis (placebo, control), increased hydrolysis (pancreatic enzyme supplementation; 50 kU lipase) and impaired hydrolysis (orlistat 240 mg). RESULTS: Intraduodenal LCT significantly (P<0.01) increased SMA flow in all experiments over basal. The SMA flow response to fat during pancreatic enzyme supplementation (1.49 +/- 0.1 l min(-1)) was significantly (P<0.05) higher compared with placebo (1.11 +/- 0.16 l min(-1)). Lipase inhibition with orlistat did not significantly affect fat stimulated SMA flow compared with placebo: 0.89 +/- 0.08 l min(-1) versus 1.11 +/- 0.16 l min(-1). CONCLUSIONS: Administration of pancreatic enzymes significantly increases fat stimulated SMA flow. Fat digest products in the intestinal lumen contribute to the regulation of SMA blood flow.     

肠系膜上动脉彩色多普勒超声检查方法学研究

目的 建立肠系膜上动脉(SMA)彩色多普勒超声检查方法.方法 选择来我院体检的正常人40名,男女各20名.所有受试者首先对其SMA进行常规彩色多普勒超声检查,然后口服自制混合型小肠声学造影剂后,再次对其SMA进行彩色多普勒超声检查,观察其SMA主干及各级分支的彩色血流图像,测量SMA主干内径、收缩期峰值流速(PS)、阻力指数(RI)和搏动指数(PI).结果 所有受试者行常规彩色多普勒超声检查SMA中上段均可显示,其中9名可显示SMA主干全段,但其分支均未显示.口服自制混合型小肠声学造影剂后,所有受试者行彩色多普勒超声检查均能全面获得SMA主干及各级分支的彩色血流图像,显示率达100%.彩色多普勒显示SMA主干走行较直,至末端呈蝎尾状,各分支走行各异,大部分呈树枝状走行,少数分支可见迂曲回旋,SMA血管网的血流相互交织,呈网络状或菊花状,SMA分支支动脉进入肠壁间呈环状血流.男性正常人SMA主干内径为(0.692±0.059)cm,女性为(0.704±0.094)cm,两者之间的差异无统计学意义(t=-0.437,P＞0.05);男性正常人SMA主干PS为(1.089±0.328)m/s,RI 为(0.835±0.045),PI为(2.495±0.436),与女性的(1.078±0.273)m/s、(0.860±0.421)、(2.889±0.702)比较差异无统计学意义(t=0.323、-0.621、-1.079,P均＞0.05);男性正常人SMA一级分支PS为(0.520±0.226)m/s,RI为(0.772±0.066)、PI为(1.956±0.506),与女性的(0.645±0.156)m/s、(0.833±0.070)、(2.847±0.909)比较差异无统计学意义(t=-2.742、-1.698、-5.217,P均＞0.05);男性正常人SMA二级分支PS为(0.344±0.143)m/s,RI为(0.661±0.045),PI为(1.306±0.268),与女性的(0.392±0.134)m/s、(0.781±0.072)、(2.185±0.754)比较差异无统计学意义(t=-0.981、-2.571、-6.127,P均＞0.05);男性正常人肠壁间动脉PS为(0.196±0.061)m/s,RI为(0.619±0.080),PI为(1.101±0.315),与女性的(0.224±0.100)m/s、(0.716±0.072)、(1.617±0.453)比较差异无统计学意义(t=-1.018、-0.877、-1.399,P均＞0.05).结论 口服自制混合型小肠声学造影剂可对SMA主干及各级分支进行全面的彩色多普勒超声检查.     

彩色多普勒对肠系膜上动脉餐前、后血流动力学改变的研究

目的：研究正常成人肠系膜上动脉（SMA）餐前、后血流动力学改变,探讨其临床意义,方法：采用多普勒超声分别测量55例正常成人餐前、后SMA的血流参数,包括SMA的直径（D）,收缩期峰值速度（Vmax）,舒张末期速度（Vmin)时间平均速度（Vmean),及阻力指数（RI）,搏动指数（PI）,分析其差异性,并提出正常值范围,试餐用25％的葡萄糖20ml,餐后30分钟检查。结果：正常成人餐前、后SMA血流动力学各参数间存在显著差异（P＜0．05）,餐后血流速度和血流量明显高于餐前,而I和PI均显著降低。结论：认识不同生理状态下SMA血流动力学改变及其正常值范围对临床有重要意义。     

彩色多普勒超声评价腹膜透析患者肠系膜上动脉血流动力学变化

目的 通过彩色多普勒技术测量尿毒症腹膜透析(PD)患者、尿毒症非PD患者及正常健康人肠系膜上动脉(SMA)血流动力学参数,探讨PD对尿毒症患者SMA血流动力学的影响.方法 应用Philips飞凡型彩色多普勒超声诊断仪对尿毒症PD患者、尿毒症非PD患者及健康志愿者各30例进行SMA血流动力学参数测量.结果 三组间收缩期峰值流速(PSV)、管径(D)差异无统计学意义(P>0.05);尿毒症PD组阻力指数(RI)、搏动指数(PI)低于对照组及尿毒症非PD组,差异有统计学意义(P<0.05),而尿毒症非PD组与对照组间RI、PI差异无统计学意义(P>0.05);尿毒症PD组舒张末期流速(EDV)、时间平均流速TAVM、血流量Q高于对照组及尿毒症非PD组,差异有统计学意义(P<0.05),而尿毒症非PD组与对照组间EDV、TAVM、Q差异无统计学意义(P>0.05). 尿毒症PD组RI、PI与PD龄呈负相关(r=-0.91, P<0.05;r=-0.66, P<0.05).结论 彩色多普勒超声可以无创地评价尿毒症PD患者SMA血流动力学情况,其中RI、PI的下降对于PD患者SMA血流动力学损害有重要提示意义.     

Nature of Doppler perfusion index changes in patients with colorectal cancer liver metastases.

OBJECTIVE: Occult hepatic metastases from colorectal cancer result in an increase of the ratio of arterial hepatic blood flow to total hepatic blood flow, described as the Doppler perfusion index. Whether this alteration is due to an increase in arterial blood flow or a decrease in portal venous inflow has not yet been unequivocally determined. The purpose of this study was to analyze changes in hepatic perfusion in patients with liver metastases from colorectal cancer by standardization of hemodynamic parameters to body surface area. METHODS: Hemodynamic parameters (crosssectional area, blood flow, and congestive index) were measured for the common hepatic artery and portal vein with duplex color Doppler sonography in 20 patients with liver metastases and 20 healthy control subjects and evaluated relative to body surface area. RESULTS: No statistically significant differences in age, body surface area, cross-sectional area of the common hepatic artery, and congestion index of the common hepatic artery and portal vein were observed between control subjects and patients with liver metastases. Patients with liver metastases had significantly greater arterial hepatic blood flow and Doppler perfusion index and significantly smaller portal cross-sectional area portal blood flow as well as total liver blood flow (P <.001). CONCLUSIONS: This study supports the theory that the primary mechanism of alteration in liver perfusion is the reduction of portal inflow with subsequently increased arterial hepatic blood flow.     

Transvaginal gray scale and color Doppler sonography in primary ovarian cancer and metastatic tumors to the ovary.

OBJECTIVE: To compare gray scale and color Doppler features of primary and metastatic ovarian carcinomas. METHODS: Clinical, sonographic (gray scale and color Doppler), and histopathologic data of 143 patients with primary (n = 127 adnexal masses) and metastatic (n = 34 adnexal masses) ovarian cancer were reviewed. Morphologic gray scale parameters assessed were bilaterality, tumor volume, echogenicity, and presence of septa, papillary projections, or solid areas. Color Doppler parameters were presence of blood flow, tumor blood flow location (central versus peripheral), subjective impression of blood flow amount (scanty, moderate, or abundant), lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity (centimeters per second). RESULTS: No statistical differences were found in bilaterality, tumor volume, presence of septa, papillary projections or solid areas, presence of blood flow, tumor blood flow location, subjective impression of blood flow amount, lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity. Metastatic carcinomas were more frequently purely solid tumors (47% versus 26%; P = .001; likelihood ratio, 2.4; 95% confidence interval, 1.2-4.7). CONCLUSIONS: The presence of a purely solid tumor indicates a higher probability of metastatic carcinoma than primary ovarian cancer. However, with the use of gray scale and color Doppler sonography, it is difficult to differentiate primary ovarian carcinomas from metastatic tumors to the ovary.