彩色多普勒超声观测输尿管排尿评价慢性肾功能不全

本研究应用彩色多普勒超声通过对输尿管尿流的观测分析慢性肾功能不全患者排尿的特点及其与肾功能的关系,从而为判定慢性肾功能不全提供一种新的检查方法。     

彩色多普勒超声观测妊娠期输尿管排尿功能

目的探讨超声观测妊娠期输尿管排尿的特点及临床意义,为判定输尿管受压程度及泌尿功能状态、预防泌尿系疾病的发生提供依据。方法选取健康妊娠妇女45名,分别于中期妊娠和晚期妊娠进行彩色多普勒超声检查,另选取45名健康非妊娠妇女。于受检者饮水500 ml后45~60 min观测其输尿管膀胱开口处的尿流形态、排尿频率、尿流速度。结果中期妊娠和晚期妊娠时输尿管排尿频率较健康非妊娠妇女增高,尿流速度减低（P〈0.05）;仰卧位时右侧输尿管尿流速度低于左侧,左侧卧位时右侧输尿管尿流速度高于左侧,右侧卧位时左侧尿流速度高于右侧（P〈0.05）;排尿频率受体位影响不明显。结论妊娠期间适当改变体位可减轻子宫对输尿管的压迫,改善输尿管排尿状况;通过观测输尿管排尿的峰值指标,有助于判定输尿管受压程度及泌尿功能状态。     

彩色超声多普勒诊断输尿管结石的价值

目的探讨彩色超声多普勒检查诊断输尿管结石的价值。方法对80例输尿管结石患者实施彩色超声多普勒检查及诊断,回顾性分析患者的临床资料。结果本组80例均经药物、手术取石、体外碎石等治疗证实。其中彩色超声多普勒确诊率为96.25%(77/80)。结石直径0.4~1.8 cm,平均0.9 cm。右侧输尿管结石42例,左侧36例,双侧2例。输尿管上段结石34例,中段6例,下段37例。3例中段结石患者漏诊,考虑因患者肥胖腹背部脂肪堆积,加上肠气干扰,易使彩色超声声能衰减、图像模糊不清而漏诊。结论对输尿管结石患者实施彩色超声多普勒检查,具有简捷、无创、可重复及检出率高等优点,可作为诊断输尿管结石的常用方法之一。超声医生应熟悉输尿管的解剖特点,提高操作技巧。     

彩色多普勒超声诊断肾动脉瘤

目的探讨彩色多普勒超声诊断肾动脉瘤的价值。方法回顾性分析经CTA或手术证实的5例肾动脉瘤超声表现,评价病变大小、边界、位置、内部回声及血流特点。结果 4例经超声检查获得准确定位及诊断,1例误诊为胰尾囊肿;灰阶超声显示动脉局限性扩张呈球形或梭形,内部均匀无回声,其中1例瘤壁附着血栓,呈低回声;CDFI显示瘤体内部血流为涡流;PWD显示瘤体内部为动脉血流频谱。结论肾动脉瘤超声表现具有特征性,灰阶超声结合CDFI及PWD对于诊断肾动脉瘤具有重要价值。     

彩色多普勒超声对肾积水不显影的肾功能评估及其意义

目的探讨彩色多普勒超声对一侧梗阻性肾积水不显影肾脏的肾功能评估价值。方法收集48例因一侧梗阻性肾积水IVU不显影患者,应用彩色多普勒超声测定肾内动脉血流阻力指数(R I),并与肾穿刺造瘘24 h引流量比较。结果24 h引流量分别为肾无功能组(110±80)m l(31例)、肾功能改善组(430±50)m l(13例)、肾功能恢复组(720±70)m l(4例),3组间比较差异均有统计学意义(P<0.05)。肾造瘘前肾无功能组、功能改善组和功能恢复组肾内动脉R I分别为0.81±0.01、0.75±0.01、0.65±0.03,肾实质厚度分别为(0.18±0.04)cm、(0.35±0.09)cm、(0.44±0.02)cm;肾造瘘后肾内动脉R I分别为0.76±0.04、0.68±0.02、0.60±0.04,肾实质厚度分别为(0.46±0.04)cm、(0.53±0.01)cm、(0.68±0.03)cm。相关分析显示24 h引流量与R I呈显著相关性(r=0.54,P<0.05)。结论当R I>0.81时,肾功能基本不能恢复。彩色多普勒超声在IVU不显影的积水肾功能评估中有重要临床意义。     

彩色多普勒超声对无肾积水型输尿管结石的诊断价值

目的探讨彩色多普勒超声在无肾盂积水输尿管结石诊断中的价值。方珐结合利尿法,对反复肾绞痛、血尿、超声检查无肾盂积水的58例患者的各段输尿管进行多角度、多体位的追踪检查。结杲58例患者中,结石位于膀胱壁内段狭窄部48例,腹段4例,盆段1例,诊断符合率91．4％。结论结合利尿法,彩色多普勒超声在诊断无肾盂积水型输尿管结石中具有重要的临床价值。     

糖尿病肾内动脉血流彩色多普勒超声的研究进展

肾脏损害是糖尿病严重并发症之一,一旦发生肾脏损害,往往会进行性发展为肾功能衰竭,因此早期诊断糖尿病肾病,对制定防治措施,延缓病情进展有十分重要的意义.彩色多普勒血流显像(CDFI)对肾血流的测定是评价肾内动脉血流动力学的无创检测手段,能早期评价肾功能.近年来,随着超声技术的不断发展,其在诊断糖尿病的血管病变方面得到了广泛的应用,尤其是CDFI可以在二维超声基础上直观动态地显示血管管壁血流充盈及血流动力学变化的情况,这是其他影像学检查及实验室检查所不能及的,具有较高的临床价值.CDFI是评价DN肾脏局部的血流动力学变化的有效方法,在预测肾脏损害方面有一定价值.     

三维彩色多普勒超声对慢性肾炎肾血流灌注观察的意义

目的通过三维彩色多普勒超声定量分析肾内血流的灌注参数和肾功能测值的关系,了解慢性肾炎患者肾脏损害的程度。方法根据美国肾脏疾病生存质量指导（K／DOQI）诊断及分期标准选择慢性肾炎患者60例,与正常对照组30例进行比较,应用三维彩色多普勒超声,观察肾脏形态结构,并利用血流分析技术观察肾脏的血流灌注,计算血管指数、血流指数。将肾血流灌注参数与肾功能测值及肾活检病理结果进行对照。结果慢性。肾炎组与正常对照组比较存在显著差异（P〈0．05）,并随着肾功能损害越严重,差异越显著。结论三维彩色多普勒超声对慢性肾炎各期肾血流灌注观察,可以监测慢性肾炎患者的。肾损害程度。     

15例假性动脉瘤彩色多普勒超声观察

对我院1998~2006年收治经手术、血管造影证实及治疗的15例假性动脉瘤(PA)病例进行总结,探讨彩色多普勒超声在诊断PA方面的作用。1资料与方法15例均有外伤及手术史,临床表现为局部搏动性肿物,其中男13例,女2例,年龄11~69岁,平均37.6岁。检查使用仪器为ATL HDI3000型,PHILIPS EnV     

彩色多普勒血流显像及多普勒能量图在移植肾排斥反应中的应用

目的探讨彩色多普勒血流显像及多普勒能量图在检测移植肾排斥反应中的应用价值。方法对46例肾移植受者术后进行了彩色多普勒血流显像及多普勒能量图检查。根据检测结果将46例肾移植术后受者分为3组,移植肾正常组(30例)、急性排斥组(9例)和慢性排斥组(7例),并与超声引导下肾组织穿刺的病理检查结果进行比较。结果16例急、慢性排斥反应的患者移植肾动脉搏动指数及阻力指数均高于移植肾正常组;急性排斥组肾脏长径及肾皮质厚度明显大于移植肾正常组;慢性排斥反应时肾皮质厚度、肾脏长径、宽径均小于移植肾正常组。结论彩色多普勒血流显像及多普勒能量图对移植肾血流灌注及排斥反应判断有独特的优点,搏动指数、阻力指数以及肾皮质厚度可作为有无移植肾排斥的指标之一。     

Radiation induced renal arterial stenosis detected by color duplex ultrasonography: case report

The renal arterial injury , a rare complicatiofrom radiation therapy has been in literatures[1-3]Depending upon the region being irradiated,arteriadamage may occur inrenal artery and other sites sucas the carotid artery[4 ,5],coronary artery[6]abdominal aorta , mesentery artery[7 ,8]. We had a patienwith renal artery stenosis caused by radiation therapy , which was initially detected by color duplex ultrasonography .1Case ReportA59 years old male was under the care of aninternist for hyperten…     

应用彩色多普勒超声评价颈动脉内膜切除术

目的探讨二维超声和CDFI技术在颈动脉内膜切除术（CEA）术前诊断及术后疗效评价中的应用价值。方法应用二维超声和CDFI于CEA术前、术后对比观察66例颈动脉狭窄患者的血管内径、狭窄率及血流动力学参数,将术前超声检出结果与DSA结果进行对照。结果术前超声检出6例颈动脉狭窄60%～69%,53例狭窄70%～99%,7例颈动脉闭塞,与DSA相比,超声诊断准确率为95.45%（63/66）。CEA术后狭窄处颈动脉内径显著增宽,血流速度明显下降,血流动力学参数较术前有明显改善（P均〈0.001）。术后随访效果满意。结论彩色多普勒超声对颈动脉狭窄的诊断率较高,能客观反映治疗前后血流动力学改变,在CEA术前筛查诊断及术后疗效评价中均具有重要应用价值。     

彩色多普勒超声在诊断精索静脉曲张中的临床应用

目的探讨彩色多普勒超声在诊断精索静脉曲张（VC）中的临床应用价值。方法回顾性分析103例VC患者的超声声像图表现,重点观察精索静脉内径及血流方向。结果 103例患者中,VC发生于左侧96例（96/103,93.20%）,右侧2例（2/103,1.94%）,双侧5例（5/103,4.85%）。超声检测亚临床型VC 21例（21/103,20.39%）,临床型VCⅠ级26例（26/103,25.24%）,Ⅱ级34例（34/103,33.01%）,Ⅲ级22例（22/103,21.36%）。103例VC患者中,58例接受手术治疗,超声诊断与手术结果符合率达100%（58/58）。结论彩色多普勒超声可准确诊断VC,为临床诊断和治疗VC提供可靠信息,具有重要临床应用价值。     

彩色多普勒超声诊断会阴疝的价值

目的探讨彩色多普勒超声诊断会阴疝的临床价值。方法利用彩色多普勒超声对15例会阴疝患者行术前检查,观察其超声表现。结果前会阴疝14例,疝囊位于尿道与阴道之间;后会阴疝1例,疝囊位于阴道与直肠远端及肛管之间。会阴疝表现为疝囊近端与腹腔相通,远端为盲端。疝内容物为肠管时呈肠壁回声、肠腔内容物或气体回声,CDFI示肠壁少量血流信号;内容物为网膜时呈不均匀中高回声,CDFI示点状血流信号;内容物为膀胱时呈囊状无回声,CDFI示囊壁少量血流信号。其中1例合并会阴部血管瘤,1例合并会阴部纤维脂肪瘤。结论彩色多普勒超声检查可判断有无会阴疝,明确疝的类型,对诊断、鉴别诊断会阴疝具有重要价值。     

Evaluation of renal allograft function by Doppler spectrum analysis

A decreased renal function is rather common after renal transplantation. The causes of this decreased function are diverse and difficult to differentiate. Yet, duplex examination, and especially quantitative Doppler spectrum analysis of the blood velocities in the renal artery, may be an effective method for differentiating between some of these causes. Forty-five renal transplant recipients were included in this preliminary study. Doppler spectra were recorded from the renal artery to the allograft. Parameters were derived from every Doppler spectrum in order to characterize each spectrum. Renal allograft function was evaluated on the basis of a number of clinical parameters. A significant correlation was found between the clinical parameters and the Doppler spectrum parameters indicative for changes in the peripheral resistance. Patients with a normal renal allograft function showed Doppler spectra with a high diastolic flow, typical of a vascular bed with a low peripheral resistance. Patients with a decreased renal allograft function caused by a stenosis in the renal artery could be distinguished by a low peak velocity and a low pulsatility index. A decreased allograft function caused by allograft rejection or cyclosporin nephrotoxicity also led to characteristic arterial flow disturbances. In these cases, the peripheral resistance was increased, and this was primarily reflected in a decrease in the diastolic blood velocity. We conclude that quantitative analysis of the blood velocities in the renal artery by Doppler spectrum analysis seems to be a useful, noninvasive diagnostic tool that discriminates between some of the causes of a decreased renal allograft function.     

Assessment of renal function with color Doppler ultrasound in autosomal dominant polycystic kidney disease

BACKGROUND: Measurement of renal blood flow by color Doppler ultrasound is useful for assessment of renal function in a variety of renal disorders. In autosomal dominant polycystic kidney disease (ADPKD), however, it might be difficult to visualize interlobar arteries because of deformity of renal structure. To evaluate the usefulness of color Doppler in ADPKD, parameters determined by blood flow examination were compared with the results of ordinal renal function tests. METHODS: Twenty-one patients with ADPKD were examined by color Doppler ultrasound measurement. In each patient, 10 interlobar arteries in both kidneys were investigated. Minimum blood flow velocity (Vmin), maximum blood flow velocity (Vmax), mean blood flow velocity (Vmean), acceleration, resistive index and pulsatility index were measured in relation to the results of creatinine clearance, serum creatinine, blood urea nitrogen and 15 and 120 min values of the phenolsulfonphthalein test. RESULTS: In all patients, interlobar arteries were able to be visualized and blood-flow profile was measured. Although variations of Vmin, Vmax, Vmean and acceleration were relatively large, the resistive index and pulsatility index varied little in each kidney. Mean values of Vmin (P < 0.005), Vmean (P < 0.05), resistive index (P < 0.005) and pulsatility index (P < 0.005) were well correlated to creatinine clearance with statistical significance. CONCLUSIONS: In ADPKD, color Doppler ultrasound measurement is a useful method for assessment of renal function and could be used for monitoring the dynamic state of renal blood flow as a non-invasive technique.     

经阴道彩色多普勒超声诊断子宫内膜病变

目的观察经阴道彩色多普勒超声检查（TVCDU）对子宫内膜病变的诊断价值。方法对246例疑似子宫内膜病变患者行经腹壁彩色多普勒超声和TVCDU,观察子宫内膜病变的声像图特点,重点观察子宫内膜的厚度及血流分布等,并与手术及病理结果相对照。结果病理诊断子宫内膜病变242例。TVCDU诊断232例,诊断符合率为95.87%（232/242）;经腹壁彩色多普勒超声检查诊断182例,诊断符合率为75.21%（182/242）。TVCDU明显优于经腹壁彩色多普勒超声检查（P〈0.05）。结论TVCDU诊断子宫内膜病变符合率较高,且具有安全、无创等优点,可作为常规检查手段。     

彩色多普勒超声在颈动脉内膜剥脱术中的应用

目的探讨术中超声检查在颈动脉内膜剥脱术（CEA）中应用的价值。方法收集因颈内动脉重度狭窄而接受颈动脉内膜剥脱术的21例患者,术中应用超声扫查确定斑块位置、病变长度,判断颈动脉管腔内有无游离动脉内膜及小血栓等。参照Panetton标准,将术中超声检查结果分为正常、轻度异常和显著异常。结果9例患者于颈动脉缝合后超声检查发现细条带状高回声,共14处,12处轻度异常均为长度〈3mm的游离内膜片,未予特殊处理;2处显著异常,其中1处为缝入动脉管腔内的动脉外膜,1处为细带状血栓,对此2例患者均于超声引导下再次切开颈动脉、去除游离物。术后3天复查超声显示游离内膜片均自行愈合。结论CEA术中应用超声监测可以明确颈动脉斑块位置、病变范围及形态、颈动脉狭窄程度,及时发现内膜损伤等手术并发症,有助于降低术后脑卒中率及死亡率。