The Role of Color Doppler Ultrasound Arterial Mapping for Decision Making in the Treatment of Patients with Lower Extremity Peripheral Arterial Disease

Purpose: To assess the efficacy of color Doppler imaging for decision making in the treatment of patients with lower extremity peripheral arterial disease (PAD) compared to digital subtraction angiography (DSA). Materials and Methods: Color Doppler scan was done on patients suspected for lower limb PAD, a day prior to the DSA which was done by a vascular surgeon. Also, for the patients who were candidates for endovascular intervention based on the color Doppler arterial mapping results, endovascular interventions were performed at the same time if the DSA findings are correlated with the color Doppler map. The grading for evaluated segments was normal, insignificant stenosis (<50%), hemodynamically significant stenosis (≥50%) and occlusion. We yielded the diagnostic efficacy indices of Doppler for detecting arterial stenosis in each 18 different arterial segments below the renal arteries including, infrarenal aorta, common and external iliac, common femoral, superficial femoral (proximal, middle and distal segments), deep femoral, popliteal artery, tibioperoneal trunk, anterior and posterior tibial arteries (proximal, middle and distal segments) and peroneal artery (proximal and distal segments). Then, we yielded the kappa agreement between Doppler and DSA findings considering the grade of stenosis in 18 arterial segments separately. Results: Totally 115 lower extremities (2045 arterial segments) were evaluated in 90 patients [mean age: 60.8 ± 8.9 (range: 47 - 84 years old)] of which 68 (75.6%) were men. The sensitivity of color Doppler for all arterial segments was 90% or higher except for common iliac artery, distal segment of superficial femoral artery and proximal segments of anterior and posterior tibialis and peroneal arteries. However, the specificity was 89% or higher, in all arterial segments. Kappa agreement was 0.72 or higher in all segments (All P-Values 0.001). Conclusion: This study suggests that considering excellent capability of color Doppler sonography in the evaluation of lower extremity arterial disease, color Doppler arterial mapping is sufficient for decision making in the treatment of these patients and can reduce the rate of diagnostic angiography.

Evaluation of diagnosis and curative criterion for concussion patients by color three-dimensional trascrani doppler

Objective In order to offer a noninvasive and objective examination method for assessing the clinical diagnosis and eurative criterion of concussion patients,the patients color three－dimensional transcranial doppler(3D－TCD)characteristic at deferent phases,parameter and clincal manifestation were studied.Method Parameter of Median Cerebral Artery(MCA),Base Artery(BA),the average peak forwand velocity of cerebral blood flow,train figure were tested by 3D－TCD within 24 hours,3－6 days and at the end of treatment,respectively.The results were compared with clinical diagnoses and curative criterion.Result Among 135 patients who had clinically diagnosed concussion,agreeable diagnoses 101 cases,basically agreeable diagnoses 12 cases,disagreeable diagnosis 22 cases(16.2％).At the end of treatment, according to clinical determination 96 cases(71.1％)were cured,39 cases(28.9％)were improved.Wave train character,figure and diagnoses parameter of cerebral spasm caused by concussion were suggested.Conclusion To be one of the diagnostic bases and curative criterion,3D－TCD technology is performable.Meanwhile,it is a new testing objective technique for assessing curative and determining prognosis.

QUANTITATIVE ANALYSIS ON CHANGES OF HEPATIC HEMODYNAMICS AFTER TRANSCUTANEOUS ELECTRIC PULSE STIMULATION OF LOCAL POINTS BY USING COLOR DOPPLER ULTRASOUND DIAGNOSTIC APPARATUS

Objective: To evaluate the effect of transcutaneous electric pulse stimulation (TEPS) on hepatic blood flow and parenchymal microcirculation in patients with fatty liver. Methods: A total of 31 fatty liver volunteer patients were observed in this study. Changes of color Doppler energy (CDE) images before and after TEPS of local points nearby the liver were recorded by using color Doppler ultrasound diagnostic apparatus (ACUSON 128XP/10C). Sum of color pixel area (SCPA), average of color value (ACV) and SCPA×ACV (integral) of the hepatic flow images were analyzed by an image processing system, single blind method and paired t-test. Programmed TEPS (0.5- 150 Hz / 2 000 Hz , 10- 25 V ) was applied to the right Qimen (期门 LR 14)-Jingmen (京门 GB 25), Fuai (腹哀 SP 16)-Ganshu (肝俞 BL 18) respectively for 15 min. Results: Compared with basic values of pretreatment, SCPA, ACV and SCPA×ACV increased significantly (t=2.71, P<0.02; t=3.42, P<0.01; and t=8.15, P<0.001) after TEPS, meaning improvement of hepatic blood flow supply. Conclusion: TEPS of acupoints near the liver can improve hepatic blood flow and hepatic parenchymal microcirculation in patients with fatty liver.

Investigation of lacrimal sac space-occupying lesions using color doppler ultrasound, computed tomography, and computed tomography dacryocystography

AIM:To observe the imaging features of color Doppler ultrasound(CDU)and computed tomography(CT)or computed tomography dacryocystography(CT-DCG)in different types of lacrimal sac space-occupying lesions(SOLs).METHODS:This retrospective case series study included 21 patients with lacrimal sac SOLs who underwent lacrimal sac surgery between January 2018 and March 2022.The imaging features of CDU and CT or CT-DCG in these patients were extracted from the examination cloud system.The images were observed and analyzed.RESULTS:The detection rate of lacrimal SOLs between CDU(21/21,100%)and CT or CT-DCG(20/21,95.2%)had no statistically significant difference(P=1.0).CDU could detect the blood flow signals in all SOLs except mucocele and mucopeptide concretion.Among them,polyps had characteristic imaging changes on CDU and CT-DCG.The mucoceles and mucopeptide concretions had characteristic imaging changes on CDU,which could provide more information for differential diagnosis.CONCLUSION:The morphology and internal blood flow signals of lacrimal sac SOLs can be observed using CDU.CT or CT-DCG has advantages in observing structural damage around the lacrimal sac mass.Therefore,CDU may be used as a routine examination to exclude lacrimal sac SOLs before dacryocystorhinostomy in the absence of preoperative CT or CT-DCG.

Early warning study of color doppler ultrasound in children with thyroid nodules and thyroid cancer

Objective: To study the diagnostic value of color doppler ultrasound in children with thyroid nodules and thyroid cancer. Methods: A total of sixty children with thyroid nodules treated in our hospital from March 2017 to March 2018 were selected for study. All patients underwent color Doppler ultrasound diagnosis. According to the diagnostic data, benign thyroid nodules and thyroid cancer were analyzed. The nodule nature was grouped into benign nodules group and malignant nodules group. The aspect ratio and boundary of the two groups were compared in blurring, calcification, blood flow signal classification, etc. Results: A total of 95 nodules were diagnosed by color doppler ultrasonography in 60 cases of thyroid nodules. 49 cases were benign nodules. There were 80 nodules, accounting for 82.11%, 11 cases of thyroid cancer, and 15 nodules. Accounted for 15.79%. Biopsy puncture pathology confirmed 77 benign nodules and 18 malignant nodules. The pathological results were gold standard. The specificity of color Doppler ultrasound was 90%, the sensitivity was 66.67%, and the accuracy of ultrasound diagnosis was 86.32%.The two nodules were statistically significant in terms of boundary, aspect ratio, calcification, echo, and resistance index (P<0.05), but the end-diastolic blood flow velocity (EDV) and peak systolic blood flow velocity ( There was no statistical difference between the PSV levels (P>0.05).Conclusion: Color Doppler ultrasound has the advantages of simple operation, high accuracy, non-invasive and painless, and reproducible detection. The high-frequency probe can clearly display changes such as minute lesions, blood flow signals, echoes, calcifications, etc., and can diagnose thyroid cancer in time. It provides a favorable basis for clinical treatment and has important clinical warning value, especially for children with thyroid examination.

CTA和超声多普勒在腓骨瓣血供检测中的应用

目的:探讨腓骨瓣游离移植修复上下颌骨缺损术前检测小腿供区血供的方法。方法:12例患者采用游离腓骨瓣修复上下颌骨缺损,小腿供区除物理检查外,常规行彩色多普勒检查,观察腘动脉及分支的走行、口径、腓血管蒂的长度、腓动静脉的口径、皮肤穿支的口径及位置,4例发现有问题则行16层螺旋CT血管造影术(CTA)检查。结果:所有病例未发现血管变异现象,4例其他检查异常或未检出胫前动脉的患者CTA证实腘动脉及分支没有异常。术中发现与术前检查结果一致,术后12例患者均顺利愈合,供区小腿血供没有受到影响。结论:常规行血管造影检查没有必要,但彩色多普勒检查有异常时应行血管造影检查,CTA检查具有无创和直观等优点。

彩色多普勒超声对无水酒精治疗肝细胞癌早期疗效的评价

目的:探讨彩色多普勒超声评价无水酒精治疗肝细胞癌早期疗效的临床应用价值。方法:利用彩色多普勒血流显像(CDFI)、彩色多普勒能量图(CDE)检查技术,经皮无水酒精瘤内注射(PEI)治疗52例肝细胞癌(肿块直径1.65.0cm),疗程结束后一周,以CDFI及CDE血流显示的有无作为评价PEI早期疗效的观察指标,并行组织学活检病理检查。结果:52个肿块经PEI治疗后,CDFI及CDE示大部分肿块血流信号消失,小部分肿块能检出血流信号,但较治疗前明显减少。以病理检查结果为金标准,CDFI及CDE评价PEI治疗后肿瘤的灭活情况,其敏感性为:50.0%、77.8%,准确性为78.8%、90.4%,Kappa值为:0.486、0.779。结论:CDFI、CDE动态监控PEI治疗过程对指导治疗意义重大,CDFI、CDE评价PEI结果客观、可靠,CDE可以敏感而直观地显示PEI治疗后肿瘤周边及内部残存的血流信号,对指导PEI治疗、时机及靶目标的选择以提高疗效具有重要的临床应用价值。

Application value of color Doppler ultrasound in the detection of hemodynamic change in patients with chronic kidney disease

Objective:To explore the application value of color Doppler ultrasound in the detection of hemodynamic change in patients with chronic kidney disease (CKD). Methods:A total of 720 patients with CKD who were admitted in our hospital from June, 2014 to May, 2016 were included in the study and divided into CKD2 group (n=242), CKD3 group (n=230), and CKD4 group (n=248) according to K/DOQI guideline. Meanwhile, 100 healthy volunteers were served as the control group. The renal parenchymal thickness, length, width, thickness, and hemodynamics by the two-dimensional ultrasound and color Doppler ultrasound in the four groups were observed. Results:The renal parenchymal thickness, length, width, and thickness in CKD2 group were reduced when compared with the control group, but the difference was not statistically significant (P>0.05);the above indicators in CKD3 group were significantly lower than those in the control group and CKD2 group (P<0.001);and the comparison of the above indicators between CKD4 group and other three groups was statistically significant (P<0.001). The comparison of hemodynamic parameters between CKD2 group and the control group was not statistically significant (P>0.05). The various hemodynamic parameters of Vs and Vd in CKD3 group were significantly lower than those in the control group and CKD2 group (P<0.001), while the various indicators of RI were significantly higher than those in the control group and CKD2 group (P<0.001). The various hemodynamic parameters of Vs and Vd in CKD4 group were significantly lower than those in the other three groups (P<0.001), while the various indicators of RI were significantly higher than those in the other three groups (P<0.001). Conclusions:Application of color Doppler ultrasound in detection of the hemodynamic change in patients with CKD can provide a reliable evidence for the disease diagnosis, condition monitoring, and prognosis evaluation, with an important application value.

彩色与能量多普勒评价超声造影在兔实验性肾肿瘤中的诊断价值

目的 探讨自制超声微泡造影剂在兔实验性肾肿瘤灰阶对比以及血流显像中的作用。方法 新西兰兔14只,手术植入法建立VX2 肿瘤肾荷瘤模型。常规条件与造影条件下分别行二维超声、SonoCT、CDFI和PDI检测肾肿瘤。经耳缘静脉注射自制声学造影剂,随即以1ml生理盐水冲洗。以磁光盘记录声学造影前后的声像图变化,视频密度定量分析肾脏肿瘤结节中心、边缘与临近正常肾皮质的灰阶差值。观察造影前后肿瘤病灶的血流灌注、血管形态及半定量方法计数血管的数目。结果 超声造影后肾皮质灰阶信号显著增强,病灶呈低于肾皮质的负显影,轮廓清晰,形态较规则,内部回声不均质,病灶检出率由89.5 % (17/19)提高到10 0 % (19/19)。造影后CDFI主要是2级血流显示率增高达78.9% (15 /19) ,但总的血流显示率仍为89.4% (17/19) ;PDI则主要是3级血流改变巨大,由无升到5 7.9% (11/19) ,总的血流显示率则由89.4% (17/19)上升到10 0 % (19/19)。此种变化表现为血管由点显示变化为短棒状显示,可见多达11个病灶出现短暂的贯穿性血流。而造影前不能观察到血流的两个病灶也发现有点状的血流信号。结论 使用超声造影剂有助于提高肾脏微小病灶的检出率,深入了解病灶周边与内部的血流供应情况。造影PDI成像比CDFI成像具有更高的敏感性。

彩色多普勒密度量化值在诊断乳腺肿块中的价值

目的:通过与半定量分析方法的比较,评价计算机辅助定量分析彩色多普勒信号密度在乳腺癌诊断中的应用价值。材料和方法:50例乳腺肿块患者(恶性37例,良性13例),分别用半定量和计算机辅助定量分析方法检测,比较这两种方法对良、恶性乳腺肿块鉴别诊断的灵敏度、特异度和准确性。结果:良、恶性乳腺肿块CDFI等级间的差异无显著性。而良、恶性乳腺肿块CDFI密度量化值间的差异存在显著性,P<0.01。以CDFI密度量化值大于3.62(良性乳腺肿块的CDFI密度量化平均值)作为乳腺恶性肿块的诊断标准:准确性76.0%,特异度83.8%,灵敏度53.8%,均高于CDFI等级法。结论:信号密度量化分析方法由于在对彩色血流信号的识别上,并没受到主观因素的影响,因此较半定量分析方法能更客观和可靠地反映肿块内的血供情况。

彩色多普勒超声导向硬化剂治疗肝肾囊肿的疗效

目的观察彩色多普勒超声导向肝肾穿刺注射无水酒精治疗肝肾囊肿的疗效。方法在彩色多普勒超声引导下经皮穿刺肝肾囊肿抽液后向肝肾囊肿内注射无水酒精。结果158例共173个肝肾囊肿经无水酒精治疗后复查发现总治愈率为81.5%,总显效率为97.7%。其中7例患者在治疗后出现不同程度的头晕、恶心等,15例患者注入无水酒精后或拔出针后出现肝区、腰部胀痛或不同程度腹痛,休息后均可缓解,无出血、感染、剧痛等严重并发症。结论彩色多普勒超声导向能成功避开肝肾大血管和进行囊肿的鉴别诊断。

Color Doppler sonography and angioscintigraphy in hepatic Hodgkin's lymphoma

AIM:To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography (HRA) in secondary Hodgkin's hepatic lymphoma.METHODS:The research included patients with a diagnosis of Hodgkin's lymphoma with metastatic focal lesions in the liver and controls.Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal,hepatic and splenic veins were examined.Hepatic perfusion index (HPI) estimated by HRA was calculated.RESULTS:In the majority of patients,hepatomegaly was observed.Lesions were mostly hypoechoic and mixed,solitary or multiple.Some of the patients presented with dilated splenic veins and hepatofugal blood flow.A pulse wave was registered in the centre and at the margins of lymphoma.The average velocity of the pulse wave was higher at the margins (P>0.05).A continuous venous wave was found only at the margins of lymphoma.There was no linear correlation between lymphoma size and velocity of pulse and continuous wave (r=390,P<0.01).HPI was significantly lower in patients with lymphomas than in controls (P<0.05),pointing out increased arterial perfusion in comparison to portal perfusion.CONCLUSION:Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin's hepatic lymphoma and estimation of its intensity.Hepatic radionuclide angiography can additionally help in the assesment of vascularisation of liver lesions.

Color Doppler ultrasound evaluation of asphyxial neonatal left ventricular function and its correlation with target organ damage

Objective:To study the color Doppler ultrasound parameters of asphyxial neonatal left ventricular function and the correlation with target organ damage.Methods: Normal neonates, mildly asphyxial neonates and severely asphyxial neonates born in our hospital between January 2014 and December 2015 were selected as the control group (n = 46), mild asphyxia group (n= 37) and severe asphyxia group (n = 23) respectively. On the 1st day after birth, color Doppler ultrasound was used to evaluate left ventricular function, and serum was collected to determine myocardial tissue injury, brain tissue injury and brain tissue metabolism indexes. Results: Color Doppler ultrasound parameters cardiac output (CO), ejection fraction (EF) and left ventricular fraction shortening (FS) as well as serum folate and vitamin B12 content of mild asphyxia group and severe asphyxia group were significantly lower than those of control group (P<0.05) while serum creatine kinase isoenzyme (CK-MB), troponin I (cTnI), troponin T (cTnT), S100B, neuron-specific enolase (NSE), creatine kinase BB (CK-BB), glycogen phosphorylase BB (GPBB), and homocysteine (Hcy) content were significantly higher than those of control group (P<0.05);CO, FS and EF as well as serum folate and vitamin B12 content of severe asphyxia group were significantly lower than those of mild asphyxia group (P<0.05) while serum CK-MB, cTnT, cTnI, S100B, NSE, CK-BB, GPBB and Hcy content were significantly higher than those of mild asphyxia group (P<0.05).Conclusions:Color Doppler ultrasound can accurately assess asphyxial neonatal left ventricular function damage degree and is closely related to myocardial tissue injury and brain tissue injury degree.

彩色脉冲多普勒超声在肝癌与肝血管瘤鉴别诊断中的应用

目的探讨彩色及脉冲多普勒超声对肝癌与肝血管瘤的肝固有动脉(PHA)和肝静脉(HV)及其在瘤体内、外肝动、静脉异常供血及血流的鉴别诊断特征。方法对62例进行彩色多普勒检查,结合手术或穿刺活检病理证实。结果一般来说,肝癌肿瘤的血流多为Vmax>60cm/s,RI>0.50,而血管瘤的肿瘤血流Vmax≤60cm/s,RI≤0.50。肝癌PHA管径大于4mm,血流Vmax>70cm/s,RI>0.70,肝血管瘤PHA管径小于或等于4mm,血流速度一般不超过70cm/s,RI≤0.60。肝癌组中:HV波型几乎100%显示HV1型或HV2型,DV/SV>0.6者占97.6%,同时SV速度加快;肝血管瘤组中:肝静脉的HV波型均为HV0型,DV/SV<0.6。结论对肝癌与肝血管瘤进行正确鉴别诊断的最好方法是对肿瘤动脉和肝固有动脉的血流Vmax和RI参数、HV波型、DV/SV和PHA管径以及二维图像进行详细观测,综合判断。

彩色多普勒超声对原位肝移植术后血流动力学研究

目的:探讨彩色多普勒超声(CDI)在原位肝移植术后对移植肝血流动力学变化的诊断价值。方法:应用CDI连续观察6例原位肝移植患者移植肝脏形态学变化,肝动脉峰值流速(HAmax)、门静脉及肝静脉平均流速(PVmean,HVmean)等指标,并以30例健康成人男性肝脏的血流动力学参数作为正常对照组。结果:在术后2周内肝脏移植组的HAmax低于正常对照组,1周内表现更为明显;术后1周内移植肝脏组的PVmean高于正常对照组,1周后表现不明显;移植肝脏组的Hvmean与正常对照组相比无明显差异。2周后,HA、PV和HV的血流速度基本上趋于正常。结论:CDI技术对了解肝移植术后移植肝的灌注情况,及早发现肝移植术后早期的并发症有重要意义。

膀胱肿瘤的超声诊断分期及临床价值

目的探讨超声对膀胱肿瘤进行分期诊断的必要性,分期诊断的方法,以及对预后效果意义的估价。方法对56例住院手术病例,术前进行二维超声和彩色多普勒检查,术后结合病理进行对比分析。结果膀胱肿瘤分四期:T1期肿瘤19例,T2期肿瘤14例,T3期肿瘤11例,T4期肿瘤6例,符合率82%。彩超检查阳性率94.6%,膀胱镜检查阳性率96%,CT扫描检查阳性率86.4%。结论彩超检查对膀胱肿瘤的分期诊断,是早期发现膀胱肿瘤的首选方法,在临床治疗和预后效果估价中有重要价值。

疏肝化瘀汤联合西药治疗肝郁血瘀肝纤维化随机平行对照研究

[目的]观察疏肝化瘀汤联合西药治疗肝郁血瘀肝纤维化疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按就诊顺序号方法简单随机分两组;根据不同病情,恩替卡韦抗病毒,甘草酸二铵,还原型谷胱甘肽,茵栀黄等保肝降酶退黄;螺内酯,呋噻米利尿及对症治疗。对照组30例复方鳖甲软肝片,4片/次,3次/d。治疗组29例疏肝化瘀汤(柴胡12g,当归15g,赤白芍、炒白术、丹参、鳖甲^(捣碎先煎)各15g、土鳖虫10g,黄芪15g,桃仁10g,炙甘草6g,随证加减),1剂/d,水煎150mL,早晚口服。连续治疗6个月为1疗程。观测临床症状、症状积分、肝功能、肝纤四项、门静脉内径、脾静脉内径、脾脏厚度、肝脏硬度、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床痊愈18例,有效9例,无效2例,总有效率93.10%;对照组临床痊愈12例,有效8例,无效10例,总有效率66.67%;治疗组疗效优于对照组(P<0.05)。症状积分、ALT、AST、TBil、ALB、PCIII、LN、HA、IV-C、肝脏硬度改善治疗组优于对照组(P<0.01)。[结论]疏肝化瘀汤联合西药治疗肝郁血瘀肝纤维化,疗效满意,无严重不良反应,值得推广。

高频彩超诊断乳腺肿块的临床应用

目的探讨高频彩超诊断乳腺肿块的临床价值。方法应用高频彩超回顾分析经手术及病理证实的108例乳腺囊实性肿块的二维及彩色多普勒血流显像。结果本组良性肿块55.55%(60/108),其中:纤维瘤27例,纤维瘤伴导管扩张5例,单纯囊肿10例,乳腺增生病16例,脂肪瘤2例,(1例纤维瘤、1例腺病瘤被误诊为恶性肿瘤),诊断符合率96.66%(58/60);本组恶性肿块44.44%(48/108),其中:浸润性导管癌23例,浸润性髓样癌8例,单纯癌15例,乳头状癌1例,大汗腺癌1例,其中1例单纯癌被超声漏诊;诊断符合率97.91% (47/48)。结论乳腺良、恶性肿块有较典型的声像图改变,高频超声结合血流显像诊断符合率高,为乳腺疾病提供了可靠的诊断依据。

Detecting Accuracy of Three Dimensional Power Doppler (3DPD) Vascular Indices for Prenatal Diagnosis of Morbidly Adherent Placenta in Patients with Placenta Previa

Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.