肠系膜上动脉彩色多普勒超声检查方法学研究

Methodology study on the examination of superior mesenteric artery by color Doppler ultrasound

目的建立肠系膜上动脉(SMA)彩色多普勒超声检查方法。方法选择来我院体检的正常人40名,男女各20名。所有受试者首先对其SMA进行常规彩色多普勒超声检查,然后口服自制混合型小肠声学造影剂后,再次对其SMA进行彩色多普勒超声检查,观察其SMA主干及各级分支的彩色血流图像,测量SMA主干内径、收缩期峰值流速(PS)、阻力指数(RI)和搏动指数(PI)。结果所有受试者行常规彩色多普勒超声检查SMA中上段均可显示,其中9名可显示SMA主干全段,但其分支均未显示。口服自制混合型小肠声学造影剂后,所有受试者行彩色多普勒超声检查均能全面获得SMA主干及各级分支的彩色血流图像,显示率达100%。彩色多普勒显示SMA主干走行较直,至末端呈蝎尾状,各分支走行各异,大部分呈树枝状走行,少数分支可见迂曲回旋,SMA血管网的血流相互交织,呈网络状或菊花状,SMA分支支动脉进入肠壁间呈环状血流。男性正常人SMA主干内径为(0.692±0.059)cm,女性为(0.704±0.094)cm,两者之间的差异无统计学意义(t=-0.437,P>0.05);男性正常人SMA主干PS为(1.089±0.328)m/s,RI为(0.835±0.045),PI为(2.495±0.436),与女性的(1.078±0.273)m/s、(0.860±0.421)、(2.889±0.702)比较差异无统计学意义(t=0.323、-0.621、-1.079,P均>0.05);男性正常人SMA一级分支PS为(0.520±0.226)m/s,RI为(0.772±0.066)、PI为(1.956±0.506),与女性的(0.645±0.156)m/s、(0.833±0.070)、(2.847±0.909)比较差异无统计学意义(t=-2.742、-1.698、-5.217,P均>0.05);男性正常人SMA二级分支PS为(0.344±0.143)m/s,RI为(0.661±0.045),PI为(1.306±0.268),与女性的(0.392±0.134)m/s、(0.781±0.072)、(2.185±0.754)比较差异无统计学意义(t=-0.981、-2.571、-6.127,P均>0.05);男性正常人肠壁间动脉PS为(0.196±0.061)m/s,RI为(0.619±0.080),PI为(1.101±0.315),与女性的(0.224±0.100)m/s、(0.716±0.072)、(1.617±0.453)比较差异无统计学意义(t=-1.018、-0.877、-1.399,P均>0.05)。结论口服自制混合型小肠声学造影剂可对SMA主干及各级分支进行全面的彩色多普勒超声检查。

Objective To establish methodology of the superior mesenteric artery（SMA）by color Doppler ultrasound.Methods Color Doppler ultrasound examination of SMA and its branches was performed before and after giving a new type of oral administration contrast agent in 40 normal adults.Results The upper SMA can be displayed in all the study subjects through conventional color Doppler ultrasound examination,nine cases displayed all segments SMA trunk,the branches were not shown.After oral administration of self-made mixed small intestine contrast agent,the SMA trunk with all the branches could be observed in all subjects by color Doppler ultrasound examination.The SMA trunk showed as straight in color Doppler imaging with an heliconia-like end,the branches showed various shapes,mostly are dendroid branched,some are tortuous.The blood flow of SMA are intertwined with a network-like or daisy-like shape.The SMA branch blood flow into the intestinal wall in a ring pattern.After oral administration of mixed small intestine contrast agent,the whole SMA trunk and branches can be observed by color Doppler ultrasound,the artery peak systolic velocity（PS）,resistance index（RI）,pulsatility index（PI）and the diameter,of SMA were measured：male group（0.692±0.059）cm,female group（0.704±0.094）cm;artery：male group PS（1.089±0.328）m/s,RI（0.835±0.045）,PI（2.495±0.436）,female group PS（1.078±0.273）m/s,RI（0.860±0.421）,PI（2.889±0.702）;artery a branch：male group PS（0.520±0.226）m/s,RI（0.772±0.066）PI（1.956±0.506）,female group PS（0.645±0.156）m/s,RI（0.833±0.070）,PI（2.847±0.909）;Artery two branches：the male group PS（0.344±0.143）m/s,RI（0.661±0.045）,PI（1.306±0.268）.Female group PS（0.392±0.134）m/s,RI（0.781±0.072）,PI（2.185±0.754）;between arterial wall：male group PS（0.196±0.061）m/s,RI（0.619±0.080）,PI（1.101±0.315）,female group：PS（0.224±0.100）m/s,RI（0.716±0.072）,PI（1.617±0.453）.Two groups showed no significant difference（P0.05）.Conclusion Color Doppler ultrasound can be used to examine the trunk and branches of SMA.