彩色多普勒超声在腹主动脉瘤腔内修复术后内漏中的应用价值  

Color Doppler Ultrasound Diagnostic Value of Leak Complications After Abdominal Aortic Aneurysm Surgery

作　　者：王福霞[1] 王文[1] 海录[2] 崔海鸥[1] 赵威[1] 马忠[1] 

机构地区：[1]宁夏医科大学总医院心脑血管病医院超声科,银川市750004 [2]宁夏医科大学总医院心脑血管病医院放射科,银川市750004

出　　处：《中国超声医学杂志》2016年第10期908-911,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨彩色多普勒超声在腹主动脉瘤腔内修复术后内漏并发症诊断中的应用价值。方法 30例肾下型腹主动脉瘤进行腔内带膜内支架置入术后1、3、6个月行彩色多普勒超声检查,明确其并发症有无内漏、内漏的位置及内漏分型;同期,所有检查者均行CTA检查,二者对照。结果 30例检查者术后1个月彩色多普勒超声检出内漏有7例,其中Ⅰ型4例(远端3例、近端1例);Ⅱ、Ⅲ、Ⅳ型各1例);CTA检查结果显示未见Ⅳ型内漏,其余各型均与彩色多普勒超声诊断结果一致;术后3个月复查,其中Ⅰ型1例死亡,其余3例及Ⅲ型1例经临床二次治疗后,彩色多普勒超声检查内漏消失;未经治疗的1例Ⅱ型内漏仍然存在,上述结果与CTA均符合;彩色多普勒超声与CTA均未显示Ⅳ型内漏;术后6个月复查,彩色多普勒结果与CTA结果相符,均与术后3个月复查结果相同。彩色多普勒超声对腹主动脉瘤腔内修复术后内漏并发症诊断的灵敏度100%、特异度95.8%、准确度86.7%、阳性似然比23.0。结论彩色多普勒超声诊断腹主动脉瘤腔内修复术后内漏并发症特异度、灵敏度、准确度较CTA高,且无创、无辐射、可以重复操作等优势,能够为临床治疗提供可靠的依据。Objective To investigate the value of color Doppler in the diagnosis of postoperative leakage compli cations after the abdominal aortic aneurysm repair surgery. Methods After endoluminal stent surgery on infrarenal abdominal aortic aneurysm in 30 patients, color Doppler ultrasound were performed at 1.3 and 6 months after surgery. Identify whether there was internal leakage, the leak location and type of leak. At the same time, all the patients were examined by CTA as well. CTA results were compared with color Doppler ultrasound. Results Among 30 cases, in 1 month postoperative examination, color Doppler ultrasound detected 7 cases of leak, including 4 cases of type 1, 3 cases of distal end and 1 case of proximal end. 1 case each for type Ⅱ , Ⅲ ,Ⅳ. CTA examination showed no type IV leak, rests were consistent with the color Doppler diagnostic results. In 3 months postoperative review, 1 case with type Ⅰ was died, color doppler ultrasound showed the leakage disappeared for the rest three type Ⅰ cases after the sec ondary clinical treatment. Leakage was persisted in the untreated one case of type Ⅱ. These results were accordance with the CTA results. Both color Doppler ultrasound and CTA did not show the type Ⅳ leakage. In 6 months postoperative review, the results of color Doppler were accordance with the CTA. The sensitivity, Specificity, accuracy and positive likelihood ratio of color Doppler ultrasound in diagnosis of postoperative leak complications of abdominal aortic aneurysm surgery was 100%, 95.8%, 86.7% and 23.0. Conclusions Color Doppler ultrasound diagnosis of postoperative leak complications of abdominal aortic aneurysm surgery is the safe and effective method. It can provide reliable basis for clinical treatment.

关 键 词：腹主动脉瘤 腔内修复术 内漏 彩色多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.3[医药卫生—诊断学]