二维血流显像在尿毒症造瘘血管监测的应用价值

Value of B flow technique in artificial fistula in patients with uremia

目的 探讨二维血流显像 (B Flow)技术在肾衰血透患者动静脉瘘中的应用价值。方法 对 31例尿毒症患者人工动静脉瘘分别采用彩色多普勒血流图 (CDFI)、血流功率图 (PDI)和B Flow三种模式显示瘘口和动静脉侧血管情况 ,着重观察吻合口和动静脉侧血管形态、管壁情况以及管腔内血流显示情况 ,并进行血流动力学检测。结果 本组 31例检查对象 ,端端吻合 2 3例 ,端侧吻合 3例 ,侧侧吻合 2例 ,人造血管吻合 3例。吻合口平均内径 5mm。吻合口狭窄 6例 ,血栓形成 4例。B Flow技术能同时清晰显示血流和邻近背景组织 ,与CDFI、PDI结合使用可提高异常图像显示率。B Flow与CDFI、PDI比较 ,具有更高帧频、高分辨力和全景显示功能。结论 B Flow技术是监测血透患者治疗过程中造瘘血管状况的有效检测手段之一。动静脉瘘主要并发症是吻合口狭窄。

Objective To explore and understand the practical value of B Flow in arteriovenous fistula in patients with uremia for the hemodialysis.Methods Upper limbs arteriovenous fistulas in 31 patients with uremia were examined and analyzed by CDFI, PDI and B flow. It is important to observe conformation of fistula and blood vessel and examine changes on hemodynamics.Results Among these cases, 23 patients were operated with end to end anastomoses, 3 patients with end to side anastomoses,2 patients with side to side anastomoses,and 3 patients with manmade blood vessels. The average diameter of anastomotic orifice is 5 mm.There are 6 patients with the stenosis of anastomotic orifice and 4 patients with thrombus formation. B Flow technique can display blood flow and background tissue distinctly at the same time. B Flow include wide bandwidth, high frame rate and high dynamic range for high spatial, temporal and contrast resolution imaging, respectively.Conclusions B Flow is an effective detective methods in patients with uremia during hemodialysis treatment. The main complication involved in is the stenosis of anastomotic orifice, venus dilatation and thrombus formation in individual case.