彩色多普勒超声在椎动脉型颈椎病诊断中的价值

椎动脉型颈椎病(cevical spondylosis of vertebralartery type,CSA)是颈椎病的常见类型之一,临床上主要以影像学诊断为主.本文回顾高频彩色多普勒超声诊断CSA资料,总结报道如下.     

彩色多普勒超声在颈动脉体瘤诊断中的应用价值

颈动脉体瘤血管丰富,所以DSA是确定颈动脉体瘤的特异性检查手段,但此方法具有一定创伤性,CT、MRI也可诊断此病,但价格相对较高、需要造影剂增强扫描,彩色多普勒超声检查具有简便、快捷、无痛、无创、价廉、重复性好、无需造影剂、准确性高等优点,同时,可确定肿瘤分型,了解肿瘤内的血流分布情况,这对手术风险的估计、指导临床确定手术方式、降低术后并发症等尤为重要,同时它也是术后患者监测病情、随访观察的首选方法.因此彩色多普勒超声检查是目前诊断颈动脉体瘤的首选方法,具有较高的应用价值.     

肺栓塞的彩色多普勒超声心动图诊断研究

目的:探讨彩色多普勒超声心动图在诊断肺栓塞中的价值.方法:回顾分析我院确诊的66例肺栓塞患者的彩色多普勒检查,并与正常组对照.结果:肺栓塞组检出右室扩大64例(97%);右房扩大55例(83%);室间隔运动异常42例(64%);肺动脉扩张29例(44%);右心房血栓5例(7.5%);右心室血栓1例(1.5%);肺动脉血栓6例(9%),肺动脉高压100%.结论:超声心动图是一种有效诊断肺栓塞的方法,早期应用可以提高肺栓塞的诊断水平.     

介入治疗慢性动脉粥样硬化下肢单一闭塞性疾病的效果评价

目的:探讨介入治疗慢性动脉粥样硬化下肢单一闭塞性疾病的疗效以及影响因素.方法:选取慢性动脉粥样硬化下肢单一闭塞性疾病患者56例,按闭塞段分为腹主-髂动脉型17例、髂-股动脉型18例和股腘膝下动脉型21例.应用导管、导丝相配合钝性分离微夹层介入技术行闭塞管腔开通后球囊扩张,出现夹层行支架植入术.结果:经介入治疗后闭塞段开通46例(82.1%),闭塞段未开通症状无改善6例(10.7%),症状较术前加重4例(7.1%).其中腹主-髂动脉型开通率(16例,94.1%)与髂-股动脉型开通率(16例,88.9%)比较差异无统计学意义(P>0.05),腹主-髂动脉型开通率高于股腘膝下动脉型开通率(14例,66.6%)(P<0.05).闭塞动脉长度在5～10 cm的患者,腹主-髂动脉型开通率(9例,52.9%)和髂-股动脉型开通率(10例,55.5%)均高于股腘膝下动脉型开通率(7例,33.3%)(P<0.05),而前两型比较差异无统计学意义(P>0.05).股腘膝下动脉型未开通患者(7例,33.3%)闭塞两端血管侧支代偿血管(≥3支)总数(35支,平均5.00支)多于开通患者(14例,71.4%)侧支代偿血管总数(19支,平均1.36支)(P<0.05).结论:介入治疗慢性动脉粥样硬化下肢闭塞性疾病安全有效,下肢动脉闭塞位置、闭塞动脉长度和侧支循环建立丰富程度对开通闭塞段有一定影响.     

彩色多普勒左室舒张功能E/A＜1.0对诊断冠心病的价值

目的:探讨彩色多普勒E/A＜1.0对诊断冠心病的价值.方法:对健康体检老年人经行心脏彩超诊断为左室舒张功能减退,并除外先心病、心脏瓣膜病等286例,与心电图ST-T进行对比.结果:心电图ST-T呈缺血性改变者213例;心电图正常或大致正常38例,经行踏车运动试验后25例为阳性,占运动试验66%;心电图ST-T正常但有房颤、房室传导阻滞、早搏等35例,其中30例踏车运动试验25例为阳性,占运动试验83%.结论:E/A＜1.0与心电图ST-T缺血性改变的发生率有明显关系,且阳性率更高.左室舒张功能减退对老年人在除外其他心脏病后可作为诊断冠心病的一个指标.     

甲状腺超声诊断的临床价值研究

目的:探讨超声影像在甲状腺疾病诊断中的应用价值.方法:对130例甲状腺肿块患者进行二维超声和彩色多普勒超声检查,将诊断结果与术后病理检查进行对照,分析肿块的边界、形状、内部回声、包膜以及颈部淋巴结转移情况和血流情况.结果:130例甲状腺肿块病理诊断与超声诊断对照,超声诊断符合者120例,符合率为92.31%.结论:无论二维超声还是多普勒超声,在单一条件下对甲状腺疾病进行诊断都十分困难,二者结合,对甲状腺疾病的诊断有十分重要的临床价值.     

高频彩色多普勒超声对甲状腺腺瘤的诊断分析

目的 探讨高频超声对甲状腺腺瘤的诊断价值.方法 使用高频探头对87例甲状腺腺瘤的声像图特点进行价值分析.结果 甲状腺腺瘤多表现为圆形或类圆形异常团块,以单个多见,周边可见低回声晕,病灶周围可见正常甲状腺组织.彩色多普勒显示:腺瘤周围可见较丰富的动静脉血流信号,呈环状分布,腺瘤所在侧甲状腺上动脉血流速度高于健侧.结论 高频彩色多普勒超声对甲状腺腺瘤具有良好的诊断价值,在影像检查中实应作为首选.     

Value of Doppler color ultrasonography in diagnosis of arterial occlusive disease of the lower extremity. A direct comparison with percutaneous angiography

A Direct Comparison with Percutaneous Angiography: AIM: To compare colour-coded Doppler sonography (CCDS) with conventional angiography in severe occlusive vascular disease of the lower limb. METHODS: In 55 patients 1141 vessel segments were evaluated, 700 of them with atheromatous plaques, 270 with stenoses, 208 with occlusions and 6 with aneurysms. RESULTS: Deeper-seated vessels such as the abdominal aorta, the pelvic arteries, the superficial femoral artery at the level of the adductor canal and parts of the lower leg arteries are less accessible for direct CCDS. Many pathological changes however can be diagnosed indirectly by changes in the spectral wave form distal to the lesion. In superficial vascular segments (the common femoral artery, the profunda femoris artery, the superficial femoral artery above the adductor canal and the popliteal artery) image quality was excellent, more pathological changes were found, and the degree of stenosis was better estimated in comparison to angiography. CONCLUSION: The value of CCDS in patients with intermittent claudication is limited to those who have been examined with angiography e.g. before angioplasty, to follow-up examinations after vascular dilatation or surgery and to supplementary visualisation after angiography especially in readily accessible (superficial) vascular segments.     

Principles of quantitative color Doppler ultrasound of pelvic and leg arteries. Normal sample

Statistical analysis of a group of 25 healthy individuals, examined via angiodynography, shows a large range of scatter for all measured parameters in pelvic and lower extremity arteries. Blood flow and velocity values, systolic acceleration and vessel diameter decrease whereas the pulsatility index rises from the centre towards the periphery. Problem areas for morphological and quantitative evaluation are the abdominal aorta, pelvic vessels, superficial femoral artery in the distal adductor canal and the fibular artery. Nearly all vessels showed tri- or multiphasic spectral patterns. Biphasic waveform, however, may be normal in lower extremity arteries. The data yielded by colour-coded Doppler sonography were comparable to results obtained with other procedures.     

Treatment of ischemic ulcers of the lower extremities

A total of 102 cases of ischemic ulcers, some with superficial gangrene and infection, were treated in a conservative manner, including debridement when indicated. Results with the outline of care described were very encouraging, with a limb salvage rate of over 90%. It should be stressed that diligent observation and care of the patient being treated is essential.     

Doppler ultrasound evaluation of fetal renal arteries in normal pregnancy

Normal values of the pulsatility index in the fetal renal arteries in a group of 65 uncomplicated pregnancies were established. The measurements were obtained between 28 and 40 weeks of gestation. The values of pulsatility index may be used as a reference for further investigation of pathologic pregnancies.     

Thermography in lower limb arterial disease

Skin temperature distributions are described which correspond to different levels of arterial obstruction in the lower limbs. These temperature distributions are conveniently observed using thermography. Thermography may be used to measure the change in skin temperature when the limb performs work. These skin temperature changes have been correlated with the impairment of blood flow to the lower limb.     

Color Doppler ultrasound velocimetry of internal carotid arteries in normal pregnancies

BACKGROUND: There are few reports on maternal cerebral circulation during pregnancy. Using the hypothesis that cerebral blood flow resistance decreases progressively with advancing gestational age (GA) as a consequence of estrogenic effects on the vascular system during pregnancy, we calculated the pulsatility index (PI) and the mean velocity (MV) of the maternal right internal carotid artery (ICA) in order to build fitted reference centiles. METHODS: A total of 315 pregnant women with a single fetus were studied at 20-42 weeks' gestation. The patients had uncomplicated singleton pregnancies and were without any known fetal or maternal risk factors. Duplex color ultrasound with a pulsed Doppler scanner (7.5 MHz) was used to determine the PI and MV of the maternal ICA. RESULTS: Among the 315 healthy pregnant women, the PI of maternal ICA decreased progressively with advancing GA, PI50th = Exp (0.3124-0.0084 x GA), (p = 0.0003), during the second half of pregnancy. The predicted 50th percentile PI values of the ICA decreased from 1.117 (5th% = 0.755, 95th% = 1.654) at 24 weeks' gestation to 0.917 (5th% = 0.659, 95th% = 1.448) at 40 weeks' gestation. The MV of the maternal ICA also decreased progressively with advancing GA, MV50th = Exp (3.855-0.0093 x GA), (p = 0.0005), during the second half of pregnancy. The predicted 50th percentile MV values in the ICA decreased from 37.811 cm/sec (5th% = 24.177 cm/sec, 95th% = 59.138 cm/sec) at 24 weeks' gestation to 32.591 cm/sec (5th% = 20.818 cm/sec, 95th% = 51.021 cm/sec) at 40 weeks' gestation. CONCLUSIONS: Both the PI and MV of the maternal ICA decreased with GA during the second half of normal pregnancy as a result of intracerebral vessel dilatation.     

Vascular patterns of gestational trophoblastic tumors by color Doppler ultrasound

BACKGROUND: Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. METHODS: Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta-human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two-tailed Student's t-test and Fisher's exact test were used for statistical analysis. RESULTS: The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta-hCG level at diagnosis in diffuse type lesions (6608 +/- 6320 mIU/mL) was significantly lower than in the lacunar type (40462 +/- 39735 mIU/mL; P = 0.04) and compact type (212114 +/- 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 +/- 0.13) than diffuse type (0.66 +/- 0.10; P = 0.03) or compact type lesions (0.70 +/- 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. CONCLUSION: Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta-hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.