彩色多普勒超声预测子宫动静脉瘘行介入治疗的可行性探讨  

The predictive value of color Doppler imaging for the feasibility of intervention approaches in the management of uterine vascular malformations

作　　者：侯东敏[1] 张铁娟[1] 梁娜[1] 李菁华[1] 方瑞娟[1] 张晓峰[1] 

机构地区：[1]首都医科大学附属北京妇产医院,100006

出　　处：《北京医学》2016年第1期12-15,共4页Beijing Medical Journal

摘　　要：目的探讨彩色多普勒超声预测子宫动静脉瘘患者行介入治疗的可行性。方法回顾性分析2011年1月至2014年12月我院收治的23例彩色多普勒超声诊断的子宫动静脉瘘患者的临床资料,比较介入治疗组与保守治疗组的彩色多普勒测量参数(收缩期峰值血流速度PSV,阻力指数RI)。结果 23例异常阴道出血者彩色多普勒超声均观察到子宫肌层及内膜下五彩镶嵌状血流信号。频谱为高速低阻型,平均PSV为59.8 cm/s,RI为0.42。7例(7/23)行盆腔动脉造影术并行选择性子宫动脉栓塞术治愈,PSV均值为85.6cm/s,RI为0.34,4例证实为子宫动静脉瘘,3例阴性;13例(13/23)行抗感染保守治疗治愈,其中2例动脉造影检查,2例均阴性,平均PSV 50.8cm/s,RI 0.43;3例(3/23)行宫纱填塞术治愈,平均PSV 51.7 cm/s,RI 0.49。比较介入治疗组与保守治疗组的PSV均值,差异有统计学意义(P<0.05)。结论彩色多普勒超声PSV值对于超声诊断的子宫动静脉瘘患者的治疗方案选择具有临床应用价值;PSV值有望成为鉴别高危子宫动静脉瘘患者行介入性治疗的重要参考指标。Objective The aim of this study was to assess the natural outcome of uterine vascular malformations detected with ultrasonography and color Doppler, and to investigate the predictive value of color Doppler imaging for the outcome of invasive treatment. Methods This retrospective study was conducted between January 2011 and December 2014 and the data of 23 consecutive patients diagnosed with a uerine vascular malformation by ultrasonography and color Doppler imaging were analyzed. Spectral analysis included measurement of flow velocities, pulsatility index（PI） and resistance index（RI）. Close follow-up was conducted for all patients and the outcomes were recorded. Results The average values for PSV, RI were 59.8 cm/s and 0.42, respectively. Seven patients（30.4%） eventually required embolization of the uterine arteries and four of them had true arteriovenous malformations confirmed by angiography. Thirteen cases（56.5%） received conservative management and recovered. Two of the thirteen cases received angiography, and both of them were negative. The average values for PSV,RI were 50.8cm/s,RI 0.43, respectively. Three patients（13.0%） received intrauterine pack. The average values for PSV and RI were 59.8 cm/s, 0.49, respectively. Conclusion Color Doppler imaging has some value in determining the suitable treatment for patients presented with vascular malformation by ultrasonography. PSV values appear to be useful in distinguishing between low-and high-risk patients.

关 键 词：彩色多普勒超声 子宫动静脉瘘 异常出血 

分 类 号：R445.1[医药卫生—影像医学与核医学] R711.74[医药卫生—诊断学]