彩色多普勒超声在急性下肢动脉栓塞中的诊断价值研究

Research for the value of color doppler ultrasonography in diagnosis of acute lower limb artery embolization

目的探讨彩色多普勒超声在急性下肢动脉栓塞诊断中的应用价值。方法回顾性分析北京安贞医院收治的179例临床高度怀疑急性下肢动脉栓塞患者的彩色多普勒超声检查结果。结果179例患者中，153例经彩色多普勒超声诊断急性下肢动脉栓塞，发生于腹主动脉骑跨栓塞14例，髂动脉栓塞20例，股动脉80例，胴动脉24例，胭动脉以下栓塞15例。完全栓塞时，超声显示下肢动脉管腔内实性低回声充填，彩色多普勒显示动脉内血流信号中断，栓塞处无血流信号显示，脉冲多普勒频谱无血流频谱。不完全栓塞时，于血管壁一侧见细条状不规则血流，色彩明亮，远端色彩暗淡，远端呈低速低阻，舒张期反向血流消失的单相频谱。结论彩色多普勒超声检查对急性下肢动脉栓塞能快速明确诊断、确定栓塞部位和程度，是早期诊断的首选检查方式。

Objective To explore the value of color Doppler ultrasound in diagnosis of acute lower extremity arterial embolization. Methods The two-dimension and color Doppler ultrasonographic characteristics were performed in 179 cases of highly suspicious patients of acute lower extremity arterial embolization. Results All 153 cases of acute lower extremity arterial embolism were diagnosed by color Doppler. 14 cases occurred in the abdominal aorta saddle embolism and 20 cases occurred iliac artery embolization. 80 cases occurred in femoral artery. 24 cases occurred in popliteal artery. 15 cases occurred in the following popliteal artery. When the arterial was totally embolism, the ultrasound showed lower extremity arterial lumen hypoechoic solid fill; color Doppler showed the flow signal interrupt, no flow signals at arterial embolization, no-flow spectrum in the pulse Doppler Le spectrum. When the arterial were partially embolism, fine strip irregular blood flow could be seen in the vessel wall side, color bright, color dim in distal position, low low resistance and diastolic reverse flow disappeared single phase spectrum appeared in far end. Conclusions Ultrasonography is convenient and fast diagnosis method, for early diagnosis of acute lower extremity arterial embolization.