彩色多普勒超声对感染性心内膜炎致外周血管感染性假性动脉瘤的诊断价值

Diagnostic value of color doppler ultrasound in infectious pseudoaneurysms of peripheral blood vessels caused by infectious endocarditis

目的探讨彩色多普勒超声对感染性心内膜炎致外周血管感染性假性动脉瘤的诊断及疗效评估价值。方法 回顾性分析2009年1月—2018年6月首都医科大学附属北京安贞医院收治9例外周血管感染性假性动脉瘤患者的超声图像特征,主要包括动脉瘤所在位置、瘤体大小、破口宽度、附壁血栓情况。结果 9例感染性假性动脉瘤分别位于股动脉、胫前动脉、腘动脉、胫后动脉、肌间动脉、尺动脉、腮腺动脉、锁骨下动脉、肠系膜上动脉。感染性假性动脉瘤瘤体上下径(54.86±21.25)mm,前后径(40.71±15.47)mm,破口宽度(2.47±0.94)mm,附壁血栓2例。行外科手术切除治疗3例,其中1例同时行人工血管替换术;介入治疗5例,其中行弹簧圈封堵2例,单纯支架置入2例,弹簧圈封堵同时行支架置入1例;保守治疗1例。术后血管血流通畅,未见血栓形成。结论 彩色多普勒超声对感染性假性动脉瘤具有较高的诊断价值,可以作为感染性假性动脉瘤诊断及疗效评估的首选检查方法。

Objective To explore the value of color Doppler ultrasound in the diagnosis and evaluation of therapeutic effect of infective pseudoaneurysms of peripheral blood vessels caused by infective endocarditis. Methods A retrospective analysis was performed from 2009 Jan to 2018 Dec, 9 patients with infective pseudoaneurysms of peripheral blood vessels were treated in Beijing Anzhen Hospital affiliated to Capital Medical University. The characteristics of ultrasound images mainly included the location of aneurysms, the size of aneurysms, the width of ruptures, and the situation of mural thrombosis. Results Nine cases of infectious pseudoaneurysm were located in the femoral artery, anterior iliac artery, radial artery, posterior tibial artery, intermuscular artery, ulnar artery, parotid artery, subclavian artery and superior mesenteric artery. Infectious pseudoaneurysm tumors have an upper and lower diameter (54.86±21.25) mm, anteroposterior diameter (40.71±15.47) mm, rupture width (2.47±0.94) mm, and 2 cases of wall thrombus. Three cases underwent surgical resection, including 1 case of artificial vessel replacement;5 cases of interventional therapy, including 2 cases with spring coil closure, 2 cases with simple stent placement, 1 case with spring ring closure and 1 case with stent placement 1 case of conservative treatment. Postoperative vascular blood flow was smooth and no thrombosis was observed. Conclusion Color Doppler ultrasonography has high diagnostic value for infectious pseudoaneurysms, and can be used as the first choice for the diagnosis and evaluation of curative effect of infectious pseudoaneurysms.