无症状脾动脉瘤患者彩色多普勒血流显像表现

Diagnostic value of asymptomatic splenic artery aneurysm with color Doppler flow imaging

目的 分析脾动脉瘤(SAA)患者彩色多普勒血流显像(CDFI)表现,探讨CDFI对无症状SAA的诊断价值。方法 回顾性分析12例无症状SAA患者CDFI图像特征。所有患者经数字减影血管造影证实,其中9例接受了手术治疗。结果 12例SAA患者中,单发8例,多发4例。其中,2例患者2个瘤体,2例患者3个瘤体,共18个SAA。18个SAA超声正确诊断15个,诊断准确率为83.3%(15/18)。SAA的特征性CDFI表现为:脾动脉有局限性扩张膨出,瘤内显示为红蓝相间的涡流或湍流彩色血流信号,瘤体越大此特征越明显。瘤体与相连的动脉干均为单向的收缩期正向动脉血流频谱,瘤颈处测及正负双向的血流频谱。CDFI见瘤口有高速血流射入瘤体,瘤体较大者可有附壁血栓形成。结论 CDFI能可靠、无创地显示SAA及瘤体内的血流变化,适合临床对SAA进行初步筛查、诊断及动态监测。

Objective To probe into the appearance of splenic artery aneurysm (SAA) with color Doppler flow imaging(CDFI)and analyze the diagnostic value of asymptomatic SAA with CDFI.Methods Appearances of CDFI of 12 patients with asymptomatic SAA were analyzed retrospectively.They were confirmed by X-ray angiography.Nine patients received surgical therapy.Results Twelve cases with 18 aneurysms:8 cases were solitary,and 4 cases were multiple.Two cases had 2 aneurysms,and 2 cases had 3 aneurysms.Fifteen of the 18 aneurysms were diagnosed by CDFI,and the diagnosis accuracy rate was 83.3%(15/18).The characteristic appearances on CDFI in SAA were local expansion on the splenic artery,and red-blue vortex or parallel whirling flow shown inside the aneurysms.The larger the aneurysm,the more obvious the flow.The single systolic forward blood flow was found in the junction of the aneurysm body and the connected artery trunk,and the bidirectional blood flow was found in the aneurysmal neck.High speed flow was seen injecting into the aneurysm at its opening with CDFI.There was mural thrombus in the big SAA.Conclusions CDFI can reliably reveal the SAA and the changes of blood flow.CDFI is suitable for clinical preliminary screening, diagnosing and dynamic monitoring of the SAA.