经股动脉穿刺介入治疗术后动静脉瘘的彩色多普勒超声诊断

目的探讨股动脉穿刺介入治疗术后动静脉瘘的超声定位,观察动静脉瘘彩色多普勒血流动力学变化的特点,并随访患者动静脉瘘的自发闭合情况。方法采用彩色多普勒血流显像(CDFI)对13例股动脉穿刺术后动静脉瘘患者进行观察,追踪瘘口,对动静脉瘘CDFI血流动力学变化进行分析。随访动态观察瘘口愈合情况。结果所有患者CDFI均在瘘口处探及杂色高亮度血流信号,频谱显示为高速低阻的湍流,CDFI在血流射入的静脉段探及花色血流信号,表现为收缩期及舒张期连续性血流频谱,即“静脉频谱动脉化”。回访13例患者中有10例患者瘘口均自发闭合,其余3例患者瘘口呈减小趋势。结论彩色多普勒超声可及时发现股动脉穿刺术后动静脉瘘并能准确定位,亦可观察动静脉瘘口自发闭合情况,对动静脉瘘诊断、随访均具有重要价值。

Diagnoses of arteriovenous fistula after femoral artery puncture in interventional therapy by color Doppler flow imaging

Objective To explore the ultrasonic localization of arteriovenous (A-V) fistulas after femoral artery puncture in interventional therapy. To observe the hemodynamic characteristics of A-V fistula by color Doppler flow imaging(CDFI) and to follow up the self closure of A-V fistulas.Methods Thirteen patients with A-V fistulas were observed using CDFI. The characteristics of hemodynamic changes were analyzed, the fistula origin was traced and the self closure of A-V fistulas post femoral artery puncture was dynamically studied in long term follow up.Results CDFI presented impure high lighted area and spectrum indicated arterialized vena signal with high velocity and low resistance turbulence in all patients.High lighted blood signals were detected in the jet of the venous segments, and the spectral waveform demonstrated a continuous spectrum during diastolic and systolic phase. Self closure occurred in 10 patients. The fistulas tended to decrease in 3 cases.Conclusion The diagnosis and the localization of arteriovenous fistulas after femoral artery puncture can be determined by CDFI timely. Self closure can be observed in long term follow up. CDFI plays an important role in the diagnosis and follow up of A-V fistula.