经颅多普勒超声在脑动静脉畸形中应用

目的：讨论经颅多普勒超声（TCD）在脑动静脉畸形的临床应用价值既对病人的初筛．方法：用TCD对几年来就诊病人中发现的8例脑动静脉畸形病人进行总结．用4MHz连续波探头分别查颈部的颈总动脉、颈外动脉、颈内动脉、锁骨下动脉．用2MHz探头分别监测颅内大脑中动脉、大脑前动脉、颈内动脉末端、大脑后动脉同时进行压颈试验和二氧化碳反映试验及脑血流自定调节功能检测。结果：用TCD检查后发现了供血动脉高流速低搏动指数的频谱及对二氧化碳反应性和脑血流自动调节功能降低,发现了血流速增高和搏动降低与血管床有直接关系,血管床越大,血流速越快,发现了ArM对脑血流的自动调节功能扣二氧化碳反应性降低时动静脉畸形比较特异的指标．讨论：目前,脑动脉畸形患者日趋增多,用TCD检查快捷方便,对病人无损害经济实惠,对进一步脑血管造影进行初筛．     

磁共振成像和经颅多普勒评价后循环缺血的价值

目的:探讨磁共振成像(MRI)和经颅多普勒(TCD)评价后循环缺血的价值。方法:对56例诊断为后循环缺血患者的临床资料进行回顾性分析。结果:头颅MRI发现脑干、小脑、枕叶梗死灶共46个;椎基底动脉磁共振血管造影显示达39例(69.6%)双侧椎动脉不对称、粗细不均,10例(17.9%)一侧椎动脉起始段不同程度狭窄,1例锁骨下动脉狭窄。TCD显示血流速度异常者40例(71.4%),频谱异常36例(64.3%)。结论:MRI和TCD能给后循环缺血的诊断提供客观依据;MRI优于TCD。     

颅内外动脉粥样硬化性大动脉狭窄与脑梗死关系

目的:探讨动脉粥样硬化性颈动脉狭窄、颅内大脑中动脉狭窄与急性脑梗死的关系及脑梗死复发原因.方法:采用多普勒超声对136例急性脑梗死患者进行颅内外动脉检测,并对随访期间复发患者进行动脉彩色多普勒超声检测分析.结果:136例脑梗死患者大脑中动脉狭窄42例,颈动脉中、重度狭窄12例.随访期内脑梗死复发26例,其中颈动脉中、重度狭窄10例.结论:急性脑梗死与大脑中动脉严重狭窄者密切相关,复发性脑梗死与颈动脉狭窄密切相关.     

彩色多普勒超声在诊断锁骨下动脉窃血综合征中的应用

目的:通过彩色多普勒超声检测锁骨下动脉窃血综合征,为临床提供锁骨下动脉狭窄及脑缺血情况,确定治疗方案及治疗后随查.方法:对12例临床表现为椎一基底动脉供血不足和患侧上肢缺血症状的患者进行无名动脉、锁骨下动脉、颈部动脉、椎动脉的彩色多普勒超声检查,观察无名动脉或锁骨下动脉有无狭窄或闭塞.结果:锁骨下动脉狭窄4例,锁骨下动脉闭塞1例,椎动脉返流7例.结论:彩色多普勒超声为临床诊断、治疗脑血管疾病,提供了科学有效的诊断方法.     

多发性大动脉炎诊治分析

目的观察糖皮质激素联合免疫抑制剂治疗多发性大动脉炎疗效。方法回顾性分析襄阳市襄州区人民医院收治的6例多发性大动脉炎诊断治疗情况。结果 2例病情缓解,包括临床症状缓解或消失,ESR和CRP恢复正常,病情缓解后激素减量维持;1例出现病情复发,复发后联合细胞毒药物及激素治疗,糖皮质激素自始起量开始,病情得到控制;3例患者动脉狭窄严重的行介入治疗后给予小剂量激素维持治疗。结论多发性大动脉炎由于病因不明,早期无特异性症状,早期诊断较困难;确诊后,用糖皮质激素联合免疫抑制剂治疗,对于无严重动脉狭窄的患者能较好地改善症状。     

经颅多普勒超声检查对偏头痛的诊断价值

偏头痛是血管性头痛中最常见的一种类型,长期以来脑血管舒缩功能异常一直就被认为与偏头痛有关。近年来,许多学者利用经颅Doppler超声(TCD)脑血流分析技术来研究偏头痛的脑血液动力学,但其结果不尽一致。本文对124例偏头痛间歇期应用TCD检测两侧大脑中动脉(MCA)平均血流速度(MFV),并与82例正常人对照观察,以探讨TCD检查对偏头痛的诊断价值。     

颈动脉支架成形术中的微栓子监测

目的:应用经颅多普勒超声(TCD)监测颈动脉支架成形术中的微栓子信号(MES),观察各个操作步骤与MES数量的相关性。方法:对16例颈动脉严重狭窄行CAS的住院患者,在CAS术中进行全程动态MES监测,将整个CAS操作分为导丝和脑保护滤网通过狭窄部位、球囊预扩张、支架置入、球囊后扩张与回收脑保护滤网5个阶段,识别和记录各阶段的MES数据。结果:16例患者CAS术中各操作阶段均产生MES,术中监测到的MES数量是47~295个/例(中位数88个/例),其中球囊预扩及支架植入阶段TCD所监测的MES信号尤为显著,占MES总数的68.3%。术中监测到的MES均未导致临床症状出现。结论:TCD在支架成形术中的MES监测,可以评价术中微栓子脱落情况,提供与手术过程有关的卒中事件的可能发病机制,减少卒中风险。     

超声和CT诊断胆道梗阻的对比研究

目的探讨多普勒与CT在胆道梗阻诊断中的价值.方法60例胆道梗阻患者分别经多普勒与CT检查.结果对梗阻部位的诊断,CT与多普勒无明显差异,在写性方面二者有一定的区别.结论多普勒对胆道结石及良性病变所致梗阻方面优于CT,在胰头病变的诊断中CT较佳.     

浅析彩色多普勒超声诊断输尿管常见疾病的作用

目的:探讨分析应用彩色多普勒超声诊断输尿管常见疾病的作用.方法:选择528例彩超确诊的急性输尿管结石患者、287例输尿管囊肿患者观察病症特征.结果:彩超诊断输尿管疾病的准确率达95%以上,并依据诊断结果提出建议性治疗方案.结论:彩超检查作为无创无辐射的诊断方法不仅可以准确有效的进行实时判断,能重复对照检查,还便于操作,适用性广泛,作为诊断输尿管疾病的首选途径,为临床研究及选择治疗方案提供依据,具有不可忽视临床价值.     

TCD监测颅内高压症的临床研究

目的:观察颅内高压患者经颅多普勒(TCD)各项检测参数及频谱的变化,探讨TCD在监测与评估颅内高压患者颅内压的作用。方法:对我院自2007年6月至2008年6月收治的30例符合诊断的患者应用TCD进行临床监测,分析各年龄段患者TCD的各项参数(Vs、Vd、Vm、PI、RI)和血流频谱特征并与同龄段的正常对照组进行比较。结果:患者的TCD显示,Vd及Vm下降,PI、RI升高,与对照组相比有着显著性差异(P<0.01),Vs与对照组相比无显著差异(P<0.05)。同时,其血流频谱在颅内压升高的不同阶段呈现出不同的特征改变:即ICP增高初期,血流频谱表现为收缩峰变尖锐,而平均血流速度无明显改变。部分病例表现为收缩期间与舒张期血流速度均升高,频窗紊乱,Lindegaard指数(VmMCA/VmICA)>3,提示脑血管痉孪;随病情发展,脑血流速度进一步下降,频谱表现为收缩峰尖锐高阻波形。当脑血管阻力进一步增加,TCD监测频谱表现为高尖的收缩期正相血流,舒张期逆向负相血流的"振荡波",当颅内压接近舒张压时,舒张期血流消失,频谱表现为"钉子波",病情进展最终血流信号减弱直至消失。结论:TCD可直接提示脑血流灌注的状态,反映颅内压的变化,以及脑血流自动调节功能是否尚存,对于病情判断以及颅内压增高的早期干预均有重要的临床指导意义。当TCD频谱表现为收缩期血流正相而舒张期血流负相的振荡波、收缩期血流钉子波或无血流信号,预后极差。     

卵巢恶性肿瘤的CT与B超诊断对照观察

目的探讨多普勒与CT在卵巢肿瘤诊断中的应用.方法78例卵巢肿瘤分别经多普勒与CT检查,48例分别经彩色多普勒能量图(CDPI)与彩色多普勒血流图(CDFI)检查.结果卵巢恶性肿瘤以囊实性肿块为主,密度不匀,CDPI和CDFI示肿瘤以内部血流为主.结论多普勒能完整地显示肿瘤内部的血管网,CT能完整地显示肿瘤的密度,二者结合为卵巢恶性肿瘤的诊断提供了更加可靠的依据.     

基于改进细菌觅食优化的彩超图像增强算法

受彩色多普勒超声影像工作设备的限制,彩超图像作为医(疗)学辅助证据一般采用传统的算法(诸如空域增强中的直方图变换或频域增强中的小波变换)进行增强,而直方图变换后的彩超图像失真度过大,小波变换的参数调试更为繁琐。为此,本文提出了一种改进细菌觅食优化的图像增强算法。首先将彩超图像转到HSV颜色空间中,而后利用熵视觉显著性机制对亮度分量进行处理,以便获得显著性点集,将其作为细菌觅食优化初始菌群的候选集合,根据随机佳点理论抽选出合适的菌群点集后,对不完全Beta函数中的两个调节因子进行寻优,确定最优参数,最后将增强后的亮度分量整合色调分量和饱和度分量,并转回到RGB颜色空间中,得到增强后的彩超图像。文中的数据来源于某医院彩超诊断室,经MATLAB仿真测试后,证明所提算法同模因及杜鹃优化算法相比,峰值信噪比平均提高了7.29分贝,且具有良好的主观分辨效果。     

血管性痴呆患者的颈动脉彩色多普勒检查及意义

目的：利用颈动脉彩色超声检查研究血管性痴呆与颈动脉血管改变的关系。方法：选取VD组34例和正常对照组20例,全部对象均行颈动脉彩色超声检查,比较各项观察指标。结果：VD组双侧颈总动脉及双侧颈内动脉的峰值流速（PSV）和阻力指数（RI）值均数比正常对照组要大,且VD组左颈总动脉峰值流速（PSV）和阻力指数（RI）值以及左颈内动脉阻力指数（RI）值与正常对照组比较差异具有统计学意义（P〈0.05）。VaD组双侧颈动脉内膜一中膜厚度（IMT）均数均大于正常对照组,差异具有统计学意义（P〈0.05）。结论：颈动脉的血运情况可能与VD的发病相关。     

Benefits of combination of electroencephalography, short latency somatosensory evoked potentials, and transcranial Doppler techniques for confirming brain death

Objective: Optimization of combining electroencephalography (EEG), short latency somatosensory evoked potentials (SLSEP) and transcranial Doppler (TCD) techniques to diagnose brain death. Methods: One hundred and eleven patients (69 males, 42 females) from the major hospitals of Zhejiang Province were examined with portable EEG, SLSEP and TCD devices. Re-examinations occurred ≤12 h later. Results: The first examination revealed that the combination of SLSEP and EEG led to more sensitive diagnoses than the c...     

Gadobutrol at different injection rates for dynamic supra-aortic imaging by contrast-enhanced magnetic resonance angiography

The aim of this study was to compare differences in imaging quality at different injection rates of gadobutrol(Gadovist? 1.0M) for dynamic supra-aortic imaging by contrast-enhanced magnetic resonance angiography(CEM RA). In 6 healthy volunteers,dynamic CEM RA examinations were performed twice at a 7 d interval with a gadobutrol dose of 0.1 mmol given to 1 kg body mass. For the two examinations,the contrast medium was injected at rates of 1.5 mL/s and 2.0 mL/s,followed by 20 mL normal saline injected at the same rate. Using a GE Signa 3.0T M R apparatus and the time-resolved imaging of contrast kinetics(TRICKS) technique,scanning was performed continuously for 15 phases at a time resolution of about 2.4 s. Vascular reconstruction was undertaken by multiplane reconstruction and maximum intensity projection techniques. Two radiologists experienced in CEM RA diagnosis subjectively evaluated the contrast effect,vascular detail,and pseudo-shadow of all images,and graded them via a 5-point scale. With the two drug injection rates,the image quality,peak signal-to-noise ratio(SNR) and contrast-to-noise ratio(CNR) were compared for imaging of the infra-aortic arch,brachiocephalic trunk,subclavian artery(left/right),common carotid artery(left/right),internal carotid artery(left/right),and external carotid artery(left/right). Characteristics of the time-signal-intensity(T-S-I) curves were also analyzed at the two injection rates. All studies were performed successfully,without any complications. There was good image quality with both gadobutrol injection rates of 1.5 mL/s and 2.0 mL/s,and subjective scores for image quality,SNR and CNR were not significantly different between the two rates(P 0.05). The time-to-peak(TTP) from the hand dorsal vein injection site to the carotid artery ranged from 16.0 s to 27.1 s(mean 21.7 s ±3.4 s) in the 6 subjects,and was also not significantly different between the two drug injection rates(P 0.05). We conclude that dynamic CEM RA examination of the supra-aortic arch with gadobutrol injection at a rate of 1.5 mL/s was feasible,and satisfactorily reflected vascular shape and dynamic blood flow information.     

脾切除后门静脉系统血栓形成中的彩超应用

目的探讨超声在脾切除后门静脉系统血栓形成中的应用价值。方法彩色多谱勒超声在脾切除术后动态监测门静脉系统3个月。结果脾切除术后门静脉系统血栓形成24例，发病率为6．9％。术后3～20天发病。结论彩色多普勒超声检查能客观反映血栓部位、梗阻程度和血流动力学改变，为临床治疗提供客观的评价及远期随访手段。     

多途径彩色多普勒超声早期诊断异位妊娠100例临床分析

目的探讨彩色多普勒超声诊断宫外孕的特征性依据,提高宫外孕诊断的准确性。方法对临床怀疑异位妊娠患者行多途径（经阴道或腹部）彩色多普勒超声探查子宫附件区域,并与血人绒毛膜促性腺激素（HCG）检查结果比较,确诊宫外孕。结果 100例疑似宫外孕患者的超声检查中,5例因附件区未见异常包块未能确定。另95例均发现附件区包块,其中包块内实质性部分可检测到滋养血流信号57例,频谱为低阻力型;伴有不同程度的盆腹腔积液54例,双侧卵巢可同时显示85例。结论对疑似早期宫外孕的患者进行二维经阴经腹彩超检查,测量包块处滋养动脉血流频谱存在,同时测定血HCG阳性,可以早期诊断宫外孕。     

探讨经腹部及经阴道彩色多普勒超声在异位妊娠诊断中的临床价值

目的探讨经腹部及经阴道彩色多普勒超声在异位妊娠诊断中的临床价值。方法经腹部及经阴道彩色多普勒超声检查160例异位妊娠患者。结果 160例宫外孕,经手术证实输卵管妊娠129例,宫颈妊娠8例,卵巢妊娠8例,均与超声诊断相符。5例超声诊断为腹腔妊娠,其中4例手术证实为卵巢妊娠,4例超声诊断为残角子宫妊娠,3例手术证实为输卵管间质部妊娠,子宫肌壁间妊娠1例,5例超声初次检查为阴性,再次复查诊断为异位妊娠,超声诊断符合率90.6%。结论经腹及经阴道彩色多普勒超声图像直观、方便、安全,可以多次复查而无创伤性,联合运用为超声诊断异位妊娠提供更多重要的参考信息。     

Effect of Ultrafine particles on Flow Field and Transport Properties near the nterface Around a Moving Bubble

Laser Doppler Anemometer has been used to measure the flow field characteristics near the interface around a moving bubble in the presence of ultrafine particles. In order to model a moving bubble, the bubble was fixed into the counter-flow liquid by a metal mesh. Experimental materials are air and water, and the particles are complex oxidate powder. Experiments were carried out under the operating conditions: the liquid flow velocity u0 is 12.6 cm/s, the equivalent diameter de is 0.6 cm, the mass concentration of particle is 0.2%,the average particle diameter is about 10 nm and the density is 2 g/cm3. The velocity profiles of both frontal and tail-vortex areas were measured respectively. The experimental results show that the velocity fields are obviously changed in the existence of particles. In the frontal area of the bubble, both tangential and normal velocities decrease due to the presence of particles, but in tail vortex area, the tangential velocities increase remarkably, and normal velocities rise gradually from the center towards the fringe in the opposite tendency to that of no particles. The influences of flow field change in the presence of particles on gas-liquid mass transfer are analyzed and discussed.