彩色多普勒超声对颌面部血管畸形的诊断分类

Application of color Doppler ultrasound in the diagnosis and classification of vascular malformations of the maxillofacial region

目的探讨彩色多普勒超声对颌面部血管畸形病变的诊断、分类。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，根据声像图特征和血流动力学特点将血管畸形分为高流速病变和低流速病变。结果110例血管畸形中，67例二维显示形态不规则的网格状或蜂窝状混合性回声，部分伴强回声静脉石，彩色多普勒显示血流信号稀少或较丰富，供瘤动脉收缩期峰值血流速度（PSV）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，瘤内血流信号极丰富，PSV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两类病变的超声诊断正确率分别为100％和97％。结论彩色多普勒超声对血管畸形病变能作出较正确的诊断分类和鉴别诊断，对临床选择合理的治疗方案具有重要的指导意义。

Objective To explore the diagnosis classification of color Doppler ultrasound（CDU） in the vascular malformations of the maxillofaacial region. Methods The feathes of CDU of 110 cases with vascular malformations of the maxilloface were studied. According to their high resolution gray scale ultrasound and hemodynamic characteristics, 110 cases with vascular malformation were divided into high-low lesion and low-flow lesion. All high-low vascular malformation were performed digital subtraction angiography（DSA） examination. Results Among the 110 cases,67 cases showed net-like mixed echoic area with irregular shape, and there were many calcifications in lesions and CDU showed blood signal rare or relatively abundant, and peak arterial systolic flow velocity （PSV） were （28.53 ± 8.1 ） cm/s, and were diagnosed as low-flow vascular malformation. Forty-three cases showed 72 supplying arteries thickening and extra abundant blood signal and PSV were averagely （144.53 ± 38.9）cm/s,and showed low resistant artery frequency spectrum and ultrasonic diagnosis were high-flow vascular malformation. DSA examination or postoperative pathology proved that high flow and low-flow ultrasonic diagnosis accuracy rate were 100% and 97% respectively. Conclusions CDU can make correct diagnosis,classification and differential diagnosis of vascular malformations and has guiding significance in selecting appropriate clinical treatment options.