超声肾动脉血流频谱异常对主动脉缩窄的诊断价值

Ultrasonography diagnosis value of renal artery blood flow frequency spectrum for coarctation of aortic

目的探讨肾动脉血流频谱异常诊断主动脉缩窄的价值。方法对1980例高血压患者采用超声行双肾及肾血流检查,测量主肾动脉最高流速、观察肾动脉血流频谱形态,对发现双侧肾动脉血流频谱异常、主肾动脉流速正常者增加扫查腹主动脉、股动脉及心脏检查。结果 1980例中9例患者双侧肾动脉血流频谱呈低灌注压改变而主肾动脉流速正常,腹主动脉、股动脉血流频谱亦呈缺血改变;7例于胸骨上窝主动脉弓切面探查到主动脉缩窄高速血流,诊断为主动脉缩窄;2例未探及高速血流,建议计算机断层血管造影检查CTA诊断为主动脉缩窄,后经手术证实。结论超声双肾动脉血流频谱形态异常而主肾动脉流速正常,可为诊断主动脉缩窄提供新的线索和依据。

Objective To evaluate the clinical value of the abnormal renal artery blood flow spectrum with color Doppler ultrasonography in the diagnosing coarctation of aortic(CoA). Methods The 1980 cases of hypertension patients had received double kidney and renal vascular ultrasound examination for measuring and recording each patient′s peak systolic velocity(PSV) in the main renal artery(MRA) and the renal artery blood flow waveforms;vascular ultrasound examination of abdominal aorta and femoral artery and echocardiographic was done to those patients with abnormal renal artery blood flow waveforms but normal PSV in MRA. Results Among them 9 patients were found with abnormal renal artery blood flow waveforms,including the hypoperfusion blood flow waveforms,longer AT and lower AC in both MRA and intrinsic artery,but their PSV in MRA were normal,which were different from RAS. Their vascular ultrasound of abdominal aorta and femoral artery were turn to reflect low perfusion pressureblood flow waveforms too;7 CoA patients were final diagnosed by Doppler ultrasound due to findding high speed at stenosis;2 CoA patients were diagnosed by cardiac angiography. Conclusion Doppler ultrasound describing patients with abnormal renal artery blood flow waveforms and normal PSV in MRA can provide a new clew and basis for diagnosing aortic coarctation.