多普勒超声对老年人下肢自发性动静脉瘘的诊断价值

Value of color doppler ultrasonography in diagnosing lower extremity spontaneous ateriovenous fistula in elderly patients

目的探讨老年人下肢自发性动静脉瘘的多普勒超声特点及其诊断价值。方法回顾性分析经数字减影血管造影技术诊断为自发性动静脉瘘的15例下肢动脉粥样硬化老年患者，通过彩色多普勒超声观察伴行动静脉之间有无瘘口和分流血流，并对血流频谱进行分析。结果15例自发性动静脉瘘患者最后经手术证实均患有下肢动脉粥样硬化13例，其中（1）二维超声显示10例相邻动静脉之间存在瘘口，与13例术后结果比较，诊断符合率76．9％。（2）彩色多普勒（CDFI）显示12例相邻动静脉（或瘘口）局部出现“五彩镶嵌”血流，脉冲多普勒（PW）于瘘口处探及高速低阻动脉血流，与术后结果比较诊断符合率92．3％（12／13）。结论彩色多普勒超声方便、快捷、无创，可作为老年人下肢自发性动静脉瘘首选检查方法。

Objective To evaluate the value of doppler ultrasonography in diagnosing spontaneous arteriovenous fistula in the elderly. Methods Doppler flow spectrum of fifteen elderly patients with lower extremity arteriovenous fistula were detected and analyzed. Results Fistula was found in 15 patients. （ 1 ） Diagnostic agreement rate between two- dimensional ultrasonography and surgical pathology was 76. 9%. （2） The multicolored flow through fistula was detected by CDFI, and high speeded and low resistanced artery flow spectrum at fistula were detected by pulse wave （PW）. Diagnostic agreement rate between color doppler uhrasonography and surgical pathology was 92. 3%. Conclusions Color doppler uhrasonography is a simple, useful, reliable and noninvasive technique in diagnosing lower extremity spontaneous arteriovenous fistula in elderly patients.