彩色超声多普勒在肺栓塞诊断中的诊断价值

目的:探讨彩色多普勒超声对肺栓塞的诊断价值.方法:经CT肺动脉造影或核磁共振证实确诊肺栓塞患者18例,行经胸彩色多普勒超声心动图检查及下肢深静脉彩色多普勒超声检查,观察右心及肺动脉血栓回声及右心结构和功能状况、三尖瓣返流程度及肺动脉压以及下肢深静脉有无血栓栓塞.结果:18例患者中超声检查直接检出肺动脉内血栓回声4例(22.2%);有右心房、右心室增大12例,右室壁运动幅度减低8例,频谱多普勒显示三尖瓣返流峰值速度明显增大10例,肺动脉高压10例.溶栓后48h多数患者右心功能即有明显改善,一周即恢复正常;18例患者中检查出有下肢深静脉血栓12例(72.2%).结论:彩色多普勒超声对肺动脉内血栓直接检出率较低,但多数患者能检查到右心系统功能异常,在肺栓塞溶栓治疗疗效观察中具有重要价值.

Diagnostic Value of Color Doppler Imaging on Pulmonary Thromboemblism

Objective: To investigate the diagnostic value of color doppler imaging on pulmonary thromboemblism(PTE).Method: 18 cases of PTE were diagnosed by clinic.They were confirmed by CT pulmonary angiography(CTPA) and MR.All cases were checked by echocardiography and limb deep venous with color Doppler flow imaging.We observed the right heart and main pulmonary artery and the right and left branches of pulmonary artery.The pulmonary systolic arterial pressure was measured by tricuspid regurgitation.Result: 4 cases(22.2%)of the patients showed thrombus echo in the main pulmonary artery and the right and left branches of pulmonary artery.12 cases(72.2%) showed the indirect signs of PTE,which were dilatation of right atrium and ventricle as well as pulmonary hypertension.In addition,12 patients were found the limb deep venous thrombosis.Conclusion: Color doppler imaging is not the good method to showed the thrombus in pulmonary artery,but most patients canbe finded the indirect signs of PTE.It is the main method to observe the treatment reaction.