全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2013年
5期
504-507
,共4页
龚海英%朱恒泉%李琴%朱映红%候小博%赵博文
龔海英%硃恆泉%李琴%硃映紅%候小博%趙博文
공해영%주항천%리금%주영홍%후소박%조박문
实时二维灰阶血流成像%颈动脉:动脉粥样硬化
實時二維灰階血流成像%頸動脈:動脈粥樣硬化
실시이유회계혈류성상%경동맥:동맥죽양경화
real-time two-dimensional blood flow imaging%carotid artery%atherosclerosis
目的评价二维灰阶血流成像技术在检测老年人颈动脉粥样硬化中的应用价值。方法应用二维灰阶血流成像技术检测35例伴有基础疾病的老年患者颈动脉,记录斑块数量、位置、大小、表面形态、内部结构及内部回声等。观察颈动脉血流充盈情况,与常规二维超声、彩色多普勒血流成像及能量多普勒血流成像结果进行比较。结果四种模式之间对异常内膜的检出率总体上差异有统计学意义(χ2=15.06,P<0.05),且二维超声组异常内膜检出率高于能量多普勒血流成像组,差异有统计学意义(χ2=7.55,P<0.05),实时二维灰阶血流成像技术组异常内膜检出率高于能量多普勒血流成像组,差异有统计学意义(χ2=9.97,P<0.05)。四种模式之间对颈动脉低回声斑块的检出率差异无统计学意义(χ2=0.37,P>0.05),但实时二维灰阶血流成像技术对低回声斑块的检出率最高(24.13%)。12条正常颈动脉的二维灰阶血流成像声像图显示动脉壁结构层次分明,内膜纤细光滑,血管内血流回声均匀一致。29条颈动脉斑块的二维灰阶血流成像则表现动脉壁不光滑,10例硬斑和12例混合斑及7例软斑均表现为内膜粗糙不平或有斑块突入管腔,二维灰阶血流成像在斑块处呈“蚕蚀”现象。颈动脉分叉处血流呈旋涡状,回声强弱不均。结论二维灰阶血流成像技术以高帧频和高空间分辨力在显示血管解剖结构的同时,实时显示动脉分叉和狭窄的病损以及血流动力学改变,可以为研究动脉粥样硬化的发生与发展以及采取相应的预防与治疗措施提供直观的影像学资料。
目的評價二維灰階血流成像技術在檢測老年人頸動脈粥樣硬化中的應用價值。方法應用二維灰階血流成像技術檢測35例伴有基礎疾病的老年患者頸動脈,記錄斑塊數量、位置、大小、錶麵形態、內部結構及內部迴聲等。觀察頸動脈血流充盈情況,與常規二維超聲、綵色多普勒血流成像及能量多普勒血流成像結果進行比較。結果四種模式之間對異常內膜的檢齣率總體上差異有統計學意義(χ2=15.06,P<0.05),且二維超聲組異常內膜檢齣率高于能量多普勒血流成像組,差異有統計學意義(χ2=7.55,P<0.05),實時二維灰階血流成像技術組異常內膜檢齣率高于能量多普勒血流成像組,差異有統計學意義(χ2=9.97,P<0.05)。四種模式之間對頸動脈低迴聲斑塊的檢齣率差異無統計學意義(χ2=0.37,P>0.05),但實時二維灰階血流成像技術對低迴聲斑塊的檢齣率最高(24.13%)。12條正常頸動脈的二維灰階血流成像聲像圖顯示動脈壁結構層次分明,內膜纖細光滑,血管內血流迴聲均勻一緻。29條頸動脈斑塊的二維灰階血流成像則錶現動脈壁不光滑,10例硬斑和12例混閤斑及7例軟斑均錶現為內膜粗糙不平或有斑塊突入管腔,二維灰階血流成像在斑塊處呈“蠶蝕”現象。頸動脈分扠處血流呈鏇渦狀,迴聲彊弱不均。結論二維灰階血流成像技術以高幀頻和高空間分辨力在顯示血管解剖結構的同時,實時顯示動脈分扠和狹窄的病損以及血流動力學改變,可以為研究動脈粥樣硬化的髮生與髮展以及採取相應的預防與治療措施提供直觀的影像學資料。
목적평개이유회계혈류성상기술재검측노년인경동맥죽양경화중적응용개치。방법응용이유회계혈류성상기술검측35례반유기출질병적노년환자경동맥,기록반괴수량、위치、대소、표면형태、내부결구급내부회성등。관찰경동맥혈류충영정황,여상규이유초성、채색다보륵혈류성상급능량다보륵혈류성상결과진행비교。결과사충모식지간대이상내막적검출솔총체상차이유통계학의의(χ2=15.06,P<0.05),차이유초성조이상내막검출솔고우능량다보륵혈류성상조,차이유통계학의의(χ2=7.55,P<0.05),실시이유회계혈류성상기술조이상내막검출솔고우능량다보륵혈류성상조,차이유통계학의의(χ2=9.97,P<0.05)。사충모식지간대경동맥저회성반괴적검출솔차이무통계학의의(χ2=0.37,P>0.05),단실시이유회계혈류성상기술대저회성반괴적검출솔최고(24.13%)。12조정상경동맥적이유회계혈류성상성상도현시동맥벽결구층차분명,내막섬세광활,혈관내혈류회성균균일치。29조경동맥반괴적이유회계혈류성상칙표현동맥벽불광활,10례경반화12례혼합반급7례연반균표현위내막조조불평혹유반괴돌입관강,이유회계혈류성상재반괴처정“잠식”현상。경동맥분차처혈류정선와상,회성강약불균。결론이유회계혈류성상기술이고정빈화고공간분변력재현시혈관해부결구적동시,실시현시동맥분차화협착적병손이급혈류동역학개변,가이위연구동맥죽양경화적발생여발전이급채취상응적예방여치료조시제공직관적영상학자료。
Objective To evaluate the application of two-dimensional blood flow imaging (B-flow) in old patients with carotid atherosclerosis. Methods B-flow imaging was used to evaluate the carotid arteries of 35 old patients with cardio-vascular disease. The plaques numbers, locations, size, surface morphology, internal structure and internal echogenicities were recorded. The carotid artery blood flow filling results of conventional two-dimensional ultrasound, color doppler flow imaging and power doppler blood flow imaging were compared. Results The difference of detection rate about abnormal endometrium among four patterns was statistically significant (χ2=15.06, P<0.05). The detection rate of abnormal en-dometrium in two-dimensional ultrasound group is significantly higher than that in power doppler blood flow imaging group (χ2=7.55, P<0.05). The detection rate of abnormal endometrium in real-time two-dimensional blood flow imaging group is significantly higher than that in power doppler blood flow imaging group(χ2=9.97, P<0.05). The difference of detection rate about low echo of carotid artery plaque among four patterns was not statistically significant (χ2=0.37, P>0.05). The detection rate of the real-time two-dimensional blood flow technique for low echo plaque was the highest (24.13%). The carotid artery ultrasonogram of real-time two-dimensional blood flow imaging of 12 normal carotid artery showed that arte-rial wall structure was distinct, the intima was tenuous and smooth and the endovascular blood flow of the echo was even. The carotid artery ultrasonogram of real-time two-di-mensional blood flow imaging of 29 abnormal carotid artery showed that arterial wall structure was not smooth. While 10 cases hard spots, 12 cases mixed stain and 7 cases soft spots showed that the intima was rough or forming plaque in the lumen. The blood flow of real-time two-dimensional blood flow imaging in the plaque has “silkworm erosion”phenomenon. The blood flow in the carotid bifur-cation was spiral and the echo was uneven. Conclusion B-flow has high frame frequency and high spatial resolution. It can display the blood vessel structure and functions as well as the blood stream dynamics changes so that it can provide new information for the study of the occurrence and development of atherosclerosis and the prevention and treatment mea-sures.