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Study on Evaluation of Hemodynamic Changes of Portal Veins in Patients with Liver Cirrhosis by Color Doppler

目的　分析彩色多普勒超声对肝硬化患者门静脉血流改变的评价作用。 方法　选择2010年1月－2011年4月收治的50例肝硬化患者作为观察组，其中代偿期患者27例，失代偿期患者23例；同时设置健康对照组50名，比较两组的门静脉内径（Dpv）、门静脉平均血流速度（Vpv）、门静脉血流量（Qpv）。 结果　观察组患者的Dpv增宽，Vpv减慢，Qpv减少，与对照组比较，差异均有统计学意义（P＜0.05）；且失代偿期患者的改变更为明显，与代偿期患者间差异有统计学意义（P＜0.05）。 结论　彩色多普勒超声检查门静脉血流改变可以对肝硬化患者进行初步确诊。

Value of Color Doppler Ultrasonography and Plasma D-imer in Diagnosis of Lower Limb Venous Thrombosis

Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied. The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured, furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%, 66.7%, 97.0%, 100%, and 97.1%, and 98.4%, 83.3%, 98.4%, 83.3%, and 97.1%, respectively. The plasma D-dimer in acute phase 〔(6 451±4 012.22) μg/L〕 and subacute phase 〔(2 063±1831.35) μg/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310±66.70) μg/L〕, Plt;0.01 and Plt;0.05, which was not different from that in chronic phase 〔(466±350.52) μg/L〕. Meanwhile, the plasma D-dimer in mixed limb venous thrombosis group 〔(4 464±3 753.16) μg/L〕 and central limb venous thrombosis group 〔(2 149±1 911.53) μg/L〕 were significantly higher than that in control group (Plt;0.05 and Plt;0.01), which was not different from that in peripheral limb venous thrombosis group 〔(560±315.62) μg/L〕. Conclusion Color Doppler ultrasonography is an optimal method and the plasma D-dimer is a predictive index in diagnosis of lower limb DVT.

经阴道腔内彩色多普勒超声诊断子宫切口瘢痕妊娠的价值评估

【摘要】　目的　评估经阴道彩色多普勒超声对子宫切口瘢痕妊娠的诊断价值。　方法　对2004年9月－2011年2月经阴道彩色多普勒超声检查后并通过临床及病理确诊为子宫切口瘢痕妊娠的20例患者进行回顾性分析。　结果　20例患者中阴道彩色多普勒超声正确诊断17例（85.0%），误诊3例（15.0%）。　结论　阴道彩色多普勒超声检查对子宫切口部瘢痕妊娠的诊断有重要的价值，对临床选择正确的治疗方案有指导意义。

高尿酸血症与颈总动脉血管损害相关性的彩色多普勒超声研究

目的 应用二维超声及 M 型超声探讨高尿酸血症与颈总动脉血管损害的相关性。 方法 选择 2011 年 1 月—2015 年 12 月无高血压、高血糖、高血脂及吸烟史患者 121 例，其中高尿酸血症患者 59 例，观察颈总动脉 118 根（高尿酸血症组）；无高尿酸血症患者 62 例，观察颈总动脉 124 根（正常组）。应用二维超声分别观察颈总动脉斑块数量、测量两组患者颈总动脉内中膜厚度，应用二维引导的M型超声测量颈总动脉前壁搏动幅度（搏幅）和前壁搏幅达峰时间、前壁搏幅斜率。 结果 高尿酸血症组观察颈总动脉 118 根，共发现颈总动脉粥样斑块 83 个（70.3%）；正常组观察颈总动脉 124 根，共发现颈总动脉粥样斑块 31 个（25.0%）；两组粥样斑块数与颈总动脉总数之比差异有统计学意义（P<0.05）。高尿酸血症组与正常组颈总动脉内中膜厚度分别为（0.93±0.17）、（0.56±0.30）mm，前壁搏幅分别为（0.43±0.19）、（0.73±0.27）mm，前壁搏幅达峰时间分别为（64.5±13.3）、（64.5±14.8）ms，前壁搏幅斜率分别为（1.21±0.33）、（1.36±0.19）mm/s，两组颈总动脉内中膜厚度、血管前壁搏幅及血管前壁搏幅斜率差异有统计学意义（P<0.05），血管前壁搏幅达峰时间差异无统计学意义（P>0.05）。 结论 高尿酸血症与颈总动脉血管内皮损害及动脉粥样硬化有直接的相关性。

高频彩色多普勒超声诊断肌疝一例

股动脉穿刺后假性动脉瘤的超声诊断与治疗

目的评价彩色多普勒超声在股动脉穿刺后股动脉假性动脉瘤形成的诊断及治疗中的临床应用价值。 方法回顾性分析2011年1月－2013年11月10例股动脉穿刺后假性动脉瘤形成的彩色多普勒超声声像图表现，总结在超声引导下对假性动脉瘤进行压迫治疗的操作方法，并对治疗结果追踪复查。 结果10例患者超声均查见股动脉周围无回声团块或混合回声团，并在瘤体内查见涡流血流信号及破口处出现“双期双向”血流频谱。10例假性动脉瘤患者行超声引导下压迫治疗，7例1次按压成功，3例重复多次按压成功。 结论彩色多普勒超声诊断假性动脉瘤准确率高，是首选的检查方法。超声引导下压迫治疗股动脉穿刺后假性动脉瘤，是一种有效的治疗方法，可以作为首选。

彩色多普勒超声诊断露脑畸形伴羊膜带综合征一例

The Value of Color Doppler Flow Imaging in the Diagnosis of Iatrogenic Damaging Pseudoaneurysm

目的:探讨彩色多普勒超声在诊断冠状动脉造影术后引发的医源损伤性假性动脉瘤的临床价值。方法: 经股动脉穿刺,行冠状动脉造影术而发生的股动脉假性动脉瘤共39例,所有患者都采用高频彩色多普勒诊断仪,对动脉瘤的二维超声图像、彩色多普勒图像及脉冲多普勒图像进行分析。结果: 39例假性动脉瘤患者在穿刺部位动脉的一侧均显示一搏动性无回声区或混合性低回声区;彩色多普勒显示无回声区内呈涡流或旋转样血流信号,表现为一半红色一半蓝色;脉冲多普勒显示典型的双期双向频谱。39例假性动脉瘤彩色多普勒超声诊断完全明确。其中32例在彩色多普勒超声监控下行人工加压包扎修复。7例经血管外科手术修补治疗。结论: 彩色多普勒超声在诊断冠状动脉造影术后造成的医源损伤性假性动脉瘤,在观察动脉瘤的大小、形态、瘤体的结构,判断来源动脉破口定位上准确、简便、无创,且可在超声引导下行安全无创治疗,可作为该病诊断及治疗的首选方法。

Comparative Study on Breast Imaging Diagnostic Methods of Commonly Used

【Abstract】　Objective　To compare the accuracy of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast diseases. Methods　The diagnostic accuracy of the above three imaging methods were analyzed and compared with each other on the basis of the postoperative pathological results. ResultsFive hundreds and sixty-five cases (breast cancer: 274 cases, benign diseases: 291 cases) were examined. The sensitivity of color-doppler ultrasonography, mammography and near-infrared light scanning for diagnosing breast cancer were 83.7%(200/239), 84.2%(64/76) and 76.9%(100/130), respectively. The specificity were 88.6%(226/255), 93.2%(69/74) and 82.6%(114/138), and the accuracy were 86.2%(426/494), 88.7%(133/150) and 79.9%(214/268), respectively. Color-doppler ultrasonography and mammography were superior to near-infrared light in the item of accuracy (P＜0.05), especially for lesions of breast cancers that were less than 2 cm. The false negative rate of near-infrared light was higher (48.8%, 21/43）than those of the other methods in detecting breast cancer at early stage. The sensitivity for detecting intraductal papilloma and inflammation of breast using color-doppler ultrasonography were 58.8%(10/17) and 69.2%(18/26), respectively, which were higher than that of near-infrared light scanning 〔0 and 23.5%(4/17)， P＜0.05 and P＜0.01〕. The sensitivity and the accuracy of near-infrared light without physical examination reduced significantly, in which the sensitivity reduced from 76.9%(100/130) to 56.9%(74/130), P＜0.01, and the accuracy reduced from 79.9%(214/298) to 61.9%(166/268), P＜0.01. Conclusion　Color-doppler ultrasonography and mammography are accurate imaging methods for diagnosing breast diseases.

Clinical application of ultrasound guided Fogarty balloon catheter in arterial crisis

Objective To explore the effectiveness of arterial crisis after replantation of limb treated by ultrasound guided Fogarty balloon catheter. Methods Between January 2012 and July 2016, 27 patients suffered from arterial crisis after replantation of limb were treated with ultrasound guided Fogarty balloon catheter combined with thrombolytic anticoagulant. There were 18 males and 9 females with the age of 19-51 years (mean, 32 years). The limb mutilation position was at knee joint in 3 cases, lower limb in 9 cases, ankle joint in 6 cases, elbow joint in 2 cases, forearm in 4 cases, and wrist joint in 3 cases. The arterial crisis happened at 2.5-18 hours (mean, 7.5 hours) after limb replantation surgery. Color doppler ultrasonography was used to diagnose the arterial thrombosis, finally the anastomotic thrombosis were found in 16 cases, non-anastomotic thrombosis in 7 cases, and combined thrombosis in 4 cases. All the thrombosis were deteced in the arteries with the length of 0.8-3.9 cm. Results No complication such as vascular perforation, rupture, air embolism, thromboembolism, wound infection, or sepsis happened after operation. Arterial crisis occurred again in 3 cases at 1.5-13.5 hours after limb replantation and treated by arterial exploration, 1 case was treated successfully; 2 cases had arterial occlusion and partial necrosis of limb, and got amputation treatment at last. The rest 24 cases survived with the incision healing by first stage. In the 24 cases, 1 case suffered from acute myonephropathic metabolic syndrome and corrected after hemodialysis; 1 case suffered from acute liver functional damage and corrected by comprehensive treatment of internal medicine. The 24 patients were followed up 7-38 months (mean, 11 months). At last follow-up, blood supply of the limb was good with normal skin temperature and improved sense of feeling, activity, and swelling. According to Chinese Medical Association of hand surgery to the upper extremity function assessment standard, the results were excellent in 12 cases, good in 8 cases, and fair in 4 cases with an excellent and good rate of 83.3%. Conclusion Ultrasound guided Fogarty balloon catheter treatment of posterior replantation of arterial crisis can accurately locate the thrombosis, get the thrombus fast and invasive minimally to avoid the blind and repeated thrombectomy, and obtain certain effectiveness.