实时灰阶谐波超声造影诊断血管疾病的初步研究

目的：评价实时灰阶谐波超声造影对血管疾病的诊断价值。方法：各类血管疾病患者73例，均接受常规彩色多普勒超声与灰阶谐波造影检查，两种方法的检查结果分为：①不能得到诊断结果；②可疑诊断；③诊断明确。所有结果均经过DSA、CT及MRI检查证实。结果：常规彩色多普勒超声诊断明确的有50．7％（37／73），可疑诊断占38．4％（28／73），不能得到诊断结果的有10．9％（8／73）。结合灰阶谐波造影检查后明确诊断的有89．0％（65／73），可疑诊断有8．2％（6／73），不能得到诊断结果的有2．8％（2／73）。常规彩色多普勒超声诊断的敏感性95．7％（45／47），特异性27．8％（5／18），准确性76．9％（50／65）；谐波造影诊断的敏感性98．0％（50／51），特异性95．0％（19／20），准确性97．2％（69／71）。结论：应用实时灰阶谐波超声造影能够比较直观地反映血管流道及管壁的变化，没有角度依赖性，不存在溢出等伪像，有助于对血管疾病的诊断。

Contrast-enhanced real-time harmonic gray scale imaging in the diagnosis of vascular diseases

Objective To evaluate the ability of contrast-enhanced real-time harmonic gray scale imaging in the diagnosis of peripheral vascular diseases. Methods Seventy three patients with different vascular diseases were examined with conventional color Doppler ultrasound(CDUS) and contrast-enhanced real-time harmonic gray scale imaging.The diagnostic results were divided into three scales:(1)no diagnosis result;(2)inconclusive diagnosis;(3) conclusive diagnosis.The diagnosis results were confirmed by DSA,CT and MRI. Results Conclusive diagnosis was achieved in 50.7%(37/73) patients,inconclusive diagnosis in 38.4%(28/73),no diagnostic result in 10.9%(8/73) on conventional CDUS;the ratio was 89.0%(65/73),8.2%(6/73) and 2.8%(2/73),respectively on contrast-enhanced real-time harmonic gray scale imaging.The sensitivity,specificity and accuracy of CDUS were 95.7%(45/47),27.8%(5/18) and 6.9%(50/65),respectively,those of contrast-enhanced real-time harmonic gray scale imaging were 98.0%(50/51),95.0%(19/20) and 97.2%(69/71),respectively.Conclusions Contrast-enhanced real-time harmonic gray scale imaging depicts the margin of the vascular lumen and outer wall directly.It can supply decisive information especially in inconclusive duplex scanning in the diagnosis of peripheral vascular diseases.