高频超声联合超声造影在雷诺现象患者指掌侧固有动脉病变的应用价值

Value of the high-frequency ultrasonography combined with ultrasound contrast to assess the hemodynamic parameters of proper palmar digital artery in patients with Raynaud phenomenon

目的分析高频超声联合超声造影在雷诺现象(RP)患者指掌侧固有动脉病变的临床应用价值。方法选取确诊的45例RP患者为病例组,38例正常成年人为对照组。应用高频超声探查病例组及对照组左手无名指指掌侧固有动脉,记录血流充盈情况及收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI)等血流动力学参数,应用超声造影观察同一血管同一部位的血流充盈情况。结果病例组PSV、EDV均较对照组减低,RI、PI均较对照组增高,差异有统计学意义(P<0.05)。超声造影显示对照组左手无名指指掌侧固有动脉彩色多普勒及超声造影血流充盈无差异。病例组彩色多普勒血流显示:Ⅰ型26例、Ⅱ型13例、Ⅲ型6例,而超声造影血流显像显示:Ⅰ型27例、Ⅱ型14例、Ⅲ型4例,1例Ⅱ型超声造影后显示为Ⅰ型、2例Ⅲ型超声造影后显示为Ⅱ型。结论高频超声能够评价RP患者指掌侧固有动脉血流动力学的变化,超声造影能更准确地显示血管的通畅情况,可为RP患者手指动脉病变严重程度的诊断、治疗提供可靠的参考依据。

Objective To analyze the clinical value of high-frequency ultrasound combined with ultrasound contrast in evaluating the proper palmar digital artery lesion in patients with Raynaud phenomenon(RP).Methods Forty-five patients diagnosed with RP were selected as the case group and 38 normal adults served as a control group.The high-frequency ultrasound was used to probe the palmar artery of the left ring finger of patients,and the blood flow filling and peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI),pulsatility index(PI)and other blood hydrodynamic parameters were recorded.Ultrasound contrast should also be used to observe blood flow in the same area of the same vessel.Results The PSV and EDV of the case group were decreased,and the RI and PI increased.There were statistically significant differ-ences in the hemodynamic parameters between the case group and the control group.Contrast-enhanced ultra-sound(CEUS)showed that color Doppler and CEUS in the palmar artery of the left ring finger of 38 healthy adults in the control group had no difference.In the case group,color Doppler showed 26 typeⅠ,13 typeⅡand 6 typeⅢ.But ultrasound contrast showed 27 typeⅠ,14 typeⅡand 4 typeⅢ.There was a crossover between CDFI and ultrasound contrast in the case group.1 case showed typeⅠafter CEUS in typeⅡ,and 2 cases showed typeⅡafter CEUS in typeⅢ.Conclusion High-frequency ultrasound can be used to evaluate the changes of proper palmar digital artery hemodynamics in patients with RP,ultrasound contrast can more accurately display the changes of blood flow in the vessels,and provide a reference for the diagnosis and treat-ment of the severe finger artery disease in patients with RP.