彩色多普勒超声在颌面部血管畸形诊断、分类及疗效评价中的应用

Application of color doppler ultrasound in the diagnosis, classification and effect evaluation of vascular malformations in the maxillofacial region

目的:评价彩色多普勒超声在颌面部血管畸形诊断、分类及疗效评价中的作用。方法:对110例颌面部血管畸形进行二维及彩色多普勒超声检查,根据超声特点,将其分为高流速病变和低流速病变。对DSA检查证实为高流速血管畸形者,常规行供血动脉栓塞治疗。所有数据采用SPSS10.0软件包进行t检验和χ2检验。结果:110例血管畸形中,67例二维显示形态不规则的网格状混合性回声,部分伴强回声静脉石,多谱勒显示彩色血流稀少或较丰富,动脉收缩峰血流速度(PSV)平均为(28.53±8.1)cm/s,超声诊断为低流速血管畸形。43例显示72条供血动脉增粗,病变内血流信号极丰富,PSV平均为(144.53±38.9)cm/s,呈低阻动脉型频谱,超声诊断为高流速血管畸形。经DSA检查或术后病理证实,高流速和低流速病变的超声诊断正确率分别为100%和97.02%。43例高流速血管畸形的供血动脉全部行栓塞治疗,栓塞前、后的PSV分别为(144.53±38.9)cm/s和(86.2±36.3)cm/s,阻力指数(RI)分别为(0.55±0.04)和(0.80±0.05)(P均<0.01)。结论:彩色多普勒超声检查能对血管畸形病变做出较正确的诊断和分类,对临床选择合理的治疗方案及动脉栓塞术后疗效评价均具有重要的指导意义。

PURPOSE： To investigate the role of color Doppler uhrasound（CDU） in the diagnosis, classification and effect evaluation of vascular malformations in the maxillofacial region. METHODS： The features of CDU in 110 patients with vascular malformations of the maxillofacial region were studied. According to their high resolution gray-scale ultrasound and hemodynamic characteristics, the vascular malformations were divided into high-flow lesion and low-flow lesion. All high-flow lesions underwent digital substraction angiography （DSA） and embolization of the supplying arteries. The data were analyzed for Student＇s t test and Chi-square test with SPSS10.0 software package. RESULTS： Among the 110 patients with vascular malformation, 67 showed net-like mixed echograms with irregular shape, and there were many phleboliths within the lesions and doppler showed rare or relatively abundant blood signals,and the peak arterial systolic flow velocity （PSV） was （28.53±8.1）cm/s. These lesions were diagnosed as low-flow vascular malformation. 43 showed 72 enlarged supplying arteries and extra abundant blood signals. PSV was （144.53±38.9）cm/s in average with lower resistant artery, frequency spectrum, and the ultrasonic diagnosis was high-flow vascular malformation. DSA or postoperative pathology proved that the accuracy rate of ultrasonic diagnosis was 100% and 97.02% respectively for high-flow and lowflow lesions. The supplying arteries in 43 patients with high-flow vascular malformation were embolized, and PSV before and after embolization was （ 144.53 ±38.9 ）cm/s and （86.2 ±36.3 ）cm/s, resistance index （RI）was （0.55 ±0.04）and （0.80 ± 0.05）, respectively, P〈0.01.CONCLUSIONS：CDU can give correct diagnosis, classification of vascular malformations,which is important in selecting appropriate treatment options and evaluating the effect of arterial embolization after operation.