彩色多普勒超声在腹主动脉瘤破裂诊断中的应用价值

Value of ultrasonography for the diagnosis of ruptured abdominal aortic aneurysm

目的探讨彩色多普勒超声在腹主动脉瘤破裂诊治中的价值。方法回顾性分析14例腹主动脉瘤破裂患者的灰阶和彩色多普勒超声图像,从腹主动脉瘤发生部位、瘤体大小、瘤壁厚度、瘤体破裂部位、瘤体破裂时血管内异常回声、血管周边形成血肿、出现腹腔游离液及瘤体内彩色多普勒表现等方面进行分析,并与手术结果、CT血管成像或磁共振检查结果进行对比。结果腹主动脉瘤超声检出率100%,肾上型2例,肾下型12例,瘤体最大直径6.1～1 3.2 cm,超声诊断腹主动脉瘤壁破裂处显示率14.3%,腹主动脉瘤旁腹腔血肿显示率66.7%,腹腔积液显示率80.0%,腹膜后血肿显示率12.5%。结论超声作为可移动简便无损伤的检查方法 ,可以快速的对腹主动脉瘤破裂和其他腹腔器官肿物引起的急腹症进行鉴别,在腹主动脉瘤的发现、随访监测、腹主动脉瘤破裂急诊入院有较高的临床应用价值。

Objective To study the value of color Doppler ultrasonography for the diagnosis and treatmer/t of ruptured abdominal aortic aneurysm. Methods Gray scale and color Doppler ultrasound images of abdominal aortic aneurysm in 14 patients were retrospectively analyzed,including its location, size, thickness, ruptured site, abnormal blood vessel echo, hematoma formation around blood vessels, free intraperitoneal fluid, and color Doppler ultrsonographic findings, which were compared with those observed in operation and CT angiography or MRI. Results The abdominal aortic aneurysm was detected in the 14 patients （over the kidney in 2 patients and under the kidney in 12 patients）by ultrasonography with a detectable rate of 100%. Its maximal diameter was 6.1-13.2 cm. The ultrasound diagnostic rate of ruptured abdominal aortic aneurysm wall, its adjacent hematoma,ascites,and retroperitoneal hematoma was 14.3%/6,66.7% ,80.0% ,and 12.5%, respectively. Conclusion Ultrasonography is a simple,movable and non-invasive method for the rapid differential diagnosis of ruptured abdominal aortic aneurysm from acute abdominal pain due to other abdominal tumors,and is thus of a considerable value in discovery and follow-up of abdominal aortic aneurysm,and emergency treatment of ruptured abdominal aortic aneurysm.