彩色多普勒超声在肺动脉栓塞诊断方面的应用  

Application on pulmonary thromboembolism with color Doppler imaging

作　　者：谢玉环[1] 侯春燕[1] 陈祥洪[1] 林庆陕[1] 张玮[1] 

机构地区：[1]东莞市人民医院超声科,广东省东莞市523018

出　　处：《中国超声医学杂志》2005年第8期627-629,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨彩色多普勒超声对肺动脉栓塞的诊断价值。方法本文对临床诊断肺动脉栓塞患者12例[均经同位素肺通气灌注扫描、核磁共振(MR)及手术证实。]所有的患者行经胸超声心动图检查和下肢深静脉彩色多普勒超声检查。重点观察右心大小和功能,室间隔及右室壁运动情况及右室壁厚度,仔细观察右心系统、主肺动脉及分叉处是否有血栓状回声,彩色多普勒超声显示血流充盈状况,三尖瓣返流程度并据此估测肺动脉压。结果12例患者,超声检出肺动脉血栓直接征象7例,其中合并右室乳头肌下方血栓及三尖瓣前叶瓣环血栓各1例;下肢血栓6例。12例均有右房、右室增大,伴有三尖瓣重度返流,肺动脉重度高压(肺动脉收缩压为110～140mmHg,即14.63～18.62kPa)。结论彩色多普勒超声是一无创、快速、简便的对肺动脉栓塞(PTE)的诊断方法,在肺动脉栓塞的疗效观察及预后判断中也起重要的作用。Objective To explore a noninvasion, fast, safe, diagnosic method for pulmonary thromboembolism （PTE） with color Doppler imaging. Methods 12 cases of PET were diagnosed by clinic, they were confirmed by MR, CT and operation. All of them were checked by echocardiography and limb deep venous color Doppler flow imaging. It is a key to observ right heart and main pulmonary artery and the right and left branches of pulmonary artery. The pulmonary systolic arterial pressure was measured by tricuspid regurgitation. Results The direct signs of 10 cases of PTE in echocardiography were the thrombus echo in right heart and main pulmonary artery and the right and left branches of pulmonary artery. The indirect signs of PTE were dilatation of right atrium and ventricle as well as pulmonary hypertension. In addition, the common cause of embolus in PTE was coming from deep venous thrombosis. Conclusions The CDFI is a fast, easy, noninvasion diagnostic method for PTE and it is helpful in the differential diagnosis from other cardiac diseases.

关 键 词：彩色多普勒超声 肺动脉栓塞 诊断 同位素肺通气灌注扫描 核磁共振 

分 类 号：R543.2[医药卫生—心血管疾病]