血流中断型四肢动脉损伤的彩色多普勒超声诊断与鉴别诊断

目的 探讨彩色多普勒超声(CDU)诊断与鉴别诊断血流中断型四肢动脉损伤的价值.方法 回顾分析36例血流中断型四肢动脉损伤患者的CDU影像资料,重点观察动脉管壁连续性、管腔通畅程度、收缩期峰值流速(Vmax)、阻力指数(RI)、频谱形态及肢体远端侧支循环形成情况,并将CDU与数字减影血管造影(DSA)或手术探查结果进行对比.结果 36例患者中,完全动脉胁迫征13例,动脉完全断裂9例,动脉内膜挫伤合并血栓形成14例.35例患者肢体远端侧支循环形成,其CDU特征为双向、低速,呈小慢波或低阻型动脉频谱.以DSA或手术探查结果为金标准,CDU的诊断准确率为72.22%(26/36).结论 CDU对血流中断型四肢动脉损伤的诊断与鉴别诊断具有较高的准确性,可为临床提供较为可靠的影像学依据.

Color Doppler ultrasonography in the diagnosis and differential diagnosis of blood interrupted extremity arterial injuries

Objective To observe the application value of color Doppler ultrasonography (CDU) in the diagnosis and differential diagnosis of blood interrupted extremity arterial injuries. Methods Ultrasonic data of 36 patients with blood interrupted extremity arterial injuries were retrospectively analyzed. The continuity of the arterial wall, unobstructed degree, maximal velocity (V_max), spectrum morphology of blood flow, resistance index (RI) and arterial collateral circulation were observed. The findings of CDU were compared with that of DSA or surgical operation. Results Among all 36 patients, artery entrapment syndrome was detected in 13 patients, complete rupture in 9 patients, intima contusion complicated with thrombosis in 14 patients, while collateral circulation in distal extremity was found in 35 of them. Doppler flow spectrum of collateral circulation showed low resistance arterial spectrum with the characteristics of two directions, slow velocity and low resistivity. Taking DSA or operation as golden standard, the diagnostic accuracy of CDU was 72.22% (26/36). Conclusion CDU has relatively high accuracy in the diagnosis and differential diagnosis of blood interrupted extremity arterial injuries, being able to provide reliable informations for clinician.