颈内静脉瓣膜功能不全彩色多普勒超声与超声造影对照研究  

A comparative study on internal jugular vein valve insufficiency by colour Doppler ultrasound and contrast- enhanced ultrasound

作　　者：张红霞[1] 何文[1] 杜丽娟[1] 李晨[1] 程令刚[1] 李肖亚[1] 

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100050

出　　处：《中华超声影像学杂志》2013年第12期1031-1035,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨颈内静脉（IJV）瓣膜功能不全及颈内静脉反流的超声表现特点。方法以40例健康志愿者的双侧颈内静脉为研究对象。应用彩色多普勒超声检测双侧UV管径、瓣膜、血流动力学参数、反向血流距离，超声造影检测双侧UV造影剂跨瓣膜反流情况，对照分析检测结果。结果80支UV中的1支左侧瓣膜缺失，共79支静脉纳入研究。右侧IJV各段内径均大于左侧但差异无统计学意义（P〉0．05）。Ijv瓣膜功能不全检出率31．6％（25／79），右侧高于左侧但差异无统计学意义（P〉0．05）；50岁及以上组UV瓣膜功能不全检出率显著高于50岁以下组（P＜0．05）。彩色多普勒显示的UV反流距离与UV瓣膜功能相关。平静呼吸功能不全瓣膜反流持续时间与功能健全瓣膜相比差异无统计学意义（P〉0．05）；功能健全瓣膜反流持续时间Valsalva呼吸与平静呼吸相比差异无统计学意义（P〉0．05）；功能不全瓣膜反流持续时间Valsalva呼吸较平静呼吸显著延长（P＜0．01）。平静呼吸与Valsalva呼吸期间功能不全瓣膜反流峰流速均显著高于功能健全瓣膜（分别为P＜O．05，P＜0．01）。结论IJV瓣膜功能不全及反流在健康人中有较高的发生率，平静呼吸和（或）Valsalva呼吸期间，反流距离、反流持续时间及反流峰流速指标在彩色多普勒超声评价UV瓣膜功能不全及反流程度中均有意义。Objective To explore the ultrasonographic characteristics of internal jugular vein（IJV） valve insufficiency and reflux. Methods 40 healthy volunteersr bilateral IJVs were study subjects. The inner diameter,valve morphological feature, reflux distance and hemodynamic parameters in IJV were detected by color Doppler ultrasound （CDU）, the contrast agents transvalvular regurgitation in IJV was monitored by contrast-enhanced ultrasound （CEUS） （with low mechanical index, MI 0.10）, then analyse the results of two methods. Results Of 80 investigated IJVs, 1 vein was % （25/79） ,which was higher on the right than that on the left,but without significant difference （P 〉 0.05）. The detection rate of IJV valve insufficiency was significantly higher in the group of greater than or equal to 50 years old than that in less than 50 years old（ P 〈0.05）. The reflux distance in IJV displayed by CDU was associated with IJV valve＇s function. Compaired with sufficient valves,the reflux duration time in insufficient valves during quiet respiration showed no significant difference （ P 〉 0.05）. During Valsalva- like manoeuvres and quiet respiration, the reflux duration time in sufficient valves showed no significant difference （ P 〉 0.05）. The reflux duration time in insufficient valves during Valsalva-like manoeuvres showed significantly higher than that during quiet respiration （ P〈 0.01）. Compaired with sufficient valves,the peak flow velocity of reflux flow in insufficient valves was significantly prolonged during quiet respiration and Valsalva-like manoeuvres （ P 〈0.05, P 〈0.01, respectively）. Conclusions The incidence rate of IJV valve insufficiency and reflux is high in healthy individuals. During quiet respiration and/or Valsalva like manoeuvres, detecting the reflux distance, reflux duration time and peak flow velocity of reflux flow by CDU are valuable in evaluating IJV valve insufficiency and the degree of IJV reflux.

关 键 词：超声检查 微气泡 颈静脉 瓣膜功能不全 

分 类 号：R445.1[医药卫生—影像医学与核医学]