彩色多普勒超声诊断血栓闭塞性脉管炎的临床价值  

Clinical value of color Doppler ultrasound in diagnosing thromboangiitis obliterans

作　　者：吴奇 梁刚 王彬[2] WU Qi;LIANG Gang;WANG Bin(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院,济南250014

出　　处：《医疗卫生装备》2023年第7期69-73,共5页Chinese Medical Equipment Journal

基　　金：山东省中医药科技发展计划项目(2019-0664)。

摘　　要：目的:探析急性期、亚急性期、慢性期血栓闭塞性脉管炎(thromboangiitis obliterans,TAO)的影像学特征及各项指标的变化,阐明彩色多普勒超声诊断血栓闭塞性脉管炎的价值。方法:选取2020年10月至2022年12月某院收治的150例TAO患者的影像资料,其中急性期43例(作为急性期组)、亚急性期75例(作为亚急性期组)、慢性期32例(作为慢性期组),使用彩色多普勒超声诊断仪观察各组血管病变位置及形态特点,记录血管内径、峰值血流速度、脉动指数、阻力指数并进行分析。结果:急性期组受累动脉壁增厚,呈细锯齿样或虫蚀样改变,管腔内呈现不规则狭窄,且脉动指数、管腔内径、血流速度较正常值稍有降低,数值从近心端到远心端呈递减趋势,而阻力指数呈递增趋势;亚急性期组受累血管节段性增宽,多有实性低回声,血栓形成处无法探及血流信号,且主要集中在胫前动脉、胫后动脉、足背动脉;慢性期组受累血管内血栓新生及机化再通交替发生,出现典型的“螺旋状”或“串珠样”血流信号,脉动指数、管腔内径、血流速度较急性期显著下降,肢体末端受累血管阻力指数上升。结论:彩色多普勒超声能够清晰地显示不同分期TAO的影像学信息及特点,可作为临床诊治TAO的重要检测方法。Objective To investigate the imaging characteristics and changes of various indexes of patients with acute,subacute and chronic thromboangiitis obliterans(TAO),and to clarify the clinical application value of color Doppler ultrasound in diagnosing thromboangiitis obliterans.Methods The imaging data of 150 patients with TAO admitted to some hospital from October 2020 to December 2022 were selected(43 patients in an acute phase group,75 patients in a sub-acute phase group and 32 patients in a chronic phase group).The location and morphological characteristics of vascular lesions in each group were observed by color Doppler ultrasound diagnostic instrument,and the inner diameter,peak blood flow velocity,pulsation index and resistance index were recorded and analyzed.Results In the acute phase group,the wall of the affected arteries was thickened and showed serrated or wormlike changes,irregular stenosis was found in the lumen,and the pulsation index,luminal diameter and blood flow velocity were slightly lower than the normal values,with the values decreasing from proximal to distal and the resistance index increasing;in the sub-acute phase group,the affected vessels were segmentally widened,mostly with solid hypoechoicity,and the blood flow signals could not be detected at the place of thrombosis,which were mainly concentrated in the anterior tibial artery,posterior tibial artery and dorsalis pedis artery;in the chronic phase group,thrombosis regeneration and organized recanalization occurred alternately,typical "spiral" or "beaded" blood flow signals appeared,and pulsation index,lumen diameter and flow velocity decreased while the resistance index of the affected vessels at the end of the limb increased significantly when compared with the acute phase group.Conclusion Color Doppler ultrasound is capable of delivering a distinct display of imaging information and characteristics of TAO at various stages with high accuracy,sensitivity and specificity,which can be adopted as a detection method for clinical diagnosis a

关 键 词：彩色多普勒超声 血栓闭塞性脉管炎 血管病变 病变分期 血流动力学 

分 类 号：R318[医药卫生—生物医学工程] R445.1[医药卫生—基础医学]