【摘要】 目的 探討外周血管動靜脈瘺的超聲特征及其鑒別診斷。 方法 回顧性分析2003年1月-2010年3月間收治的36例先天性及后天性動靜脈瘺患者的臨床資料，使用彩色超聲診斷儀觀察受累血管的內(nèi)徑、血管壁的連續(xù)性，根據(jù)血流動力學變化尋找瘺口；對受累血管血流頻譜進行分析，并與健側(cè)對照。 結(jié)果 18例先天性動靜脈瘺查見紆曲擴張的血管網(wǎng)，無法辨認瘺口；18例后天性動靜脈瘺全部可顯示瘺口，2例合并靜脈破裂的為囊瘤型，其余后天性動靜脈瘺均為洞口型。受累動脈近心端血流為高速低阻型，全部患者受累靜脈出現(xiàn)動脈樣血流，近心端靜脈呈高速低阻型頻譜；10例患者遠心端靜脈內(nèi)出現(xiàn)逆向離心血流。 結(jié)論 引流靜脈出現(xiàn)高速、動脈樣血流頻譜是動靜脈瘺的特征性表現(xiàn)；先天性動靜脈瘺可見異常血管網(wǎng)，不能辨認瘺口；后天性動靜脈瘺均可顯示瘺口。彩色超聲多普勒檢查對動靜脈瘺能夠正確診斷及鑒別診斷。
【Abstract】 Objective To observe characteristic imaging of arteriovenous fistulas (AVF) of periphery vessel, and to evaluate the differential diagnosis of AVF by ultrasonography. Methods Thirty-six patients suffering from congenital and acquired AVF in this hospital from January 2003 to March 2010 were selected to undergo Doppler ultrasonography. The blood flow of arteriovenous fistulas, diameter, morphology and blood flow characters of affected vessels were observed. Spectral of fistula and affected vessels were analyzed and compared with the healthy side. Results Deformed vascular net was observed, and the localization of arteriovenous fistulas was not observed directly in 18 congenital AVF patients.Inversely the localization of arteriovenous fistulas was observed directly in 18 acquired AVF patients.Two acquired AVF patients with venous rupture belonged to kystoma form, and others acquired AVF patients belonged to orifice form.Spectral analysis of proximal arteries of the fistula revealed high velocity and low resistance.Arterialized flow pattern was observed in affected veins.Proximal veins of the fistula revealed arterialized spectral with high velocity and low resistance.Reversed blood flow was observed in the distal veins of the fistulas in 10 patients. Conclusion Arterialized flow with high velocity in veins are characteristic signs of AVF.Deformed vascular net is observed, and the localization of arteriovenous fistulas in not observed directly in congenital AVF patients, but the localization of arteriovenous fistulas is observed directly in acquired AVF patients.Color Doppler ultrasonography has great value in confirming diagnosis and differential diagnosis of AVF.
引用本文： 文曉蓉,陳楊,黃景,羅燕,林玲. 外周血管動靜脈瘺的超聲特點分析. 華西醫(yī)學, 2010, 25(8): 1483-1485. doi: 復制
| 1. | 李治安. 臨床超聲影像學[M]. 北京: 人民衛(wèi)生出版社, 2003: 1528-1529. |
| 2. | 陸恩祥, 任衛(wèi)東. 血管超聲診斷圖譜[M]. 沈陽: 遼寧科學技術(shù)出版社, 1999: 80. |
| 3. | 段志泉, 張強. 實用血管外科學[M]. 沈陽: 遼寧科學技術(shù)出版社, 1999: 520. |
| 4. | Zwiebel WJ, 著. 溫朝陽, 等譯. 血管超聲經(jīng)典教程[M]. 第5版. 北京: 人民軍醫(yī)出版社, 2008: 300. |
- 1. 李治安. 臨床超聲影像學[M]. 北京: 人民衛(wèi)生出版社, 2003: 1528-1529.
- 2. 陸恩祥, 任衛(wèi)東. 血管超聲診斷圖譜[M]. 沈陽: 遼寧科學技術(shù)出版社, 1999: 80.
- 3. 段志泉, 張強. 實用血管外科學[M]. 沈陽: 遼寧科學技術(shù)出版社, 1999: 520.
- 4. Zwiebel WJ, 著. 溫朝陽, 等譯. 血管超聲經(jīng)典教程[M]. 第5版. 北京: 人民軍醫(yī)出版社, 2008: 300.