彩色杜普勒超音波在下肢動脈疾病的診斷－與血管攝影比較

Evaluation of Lower-Extremity Peripheral Arterial Disease with Color Doppler Ultrasound: Comparison with Angiography

龔敏凱(Mein-Kai Gueng) ； 周定遠(Ting-Ywan Chou) ； 吳清俊(Chin-Jiunn Wu) ； 蕭海松(Hai-Sung Hsiao) ； 徐先和(Hsian-He Hsu) ； 李芳豔(Fan-Yen Lee) ； 張忠毅(Chung-Yi Chang) ； 魏崢(Jeng Wei)

《中華放射線醫學雜誌》 20卷2期 (1995/06) Pp. 129-137

摘要

我們對35位下肢動脈疾病患者施行彩色超音波檢查，其中有34位並接受血管攝影檢查，疾病包含假性動脈瘤，動靜脈瘻管、動靜脈畸形、動脈狹窄和完全阻塞等5類，總計有71個病灶同時接受彩色超音波和血管攝影檢查。假性動脈瘤、動靜脈瘻管和動靜脈畸形在彩色超音波有特殊的表徵，彩色超音波能直接而精確的評估動脈狹窄的程度與血栓的性質，而且操作者司以在病人皮膚直接標示侵犯的範圍。與血管攝影比較，彩色超音波在80%(41/51)的假性動脈瘤和動脈狹窄病灶的病灶壁變化及在44%(8/18)白勺假性動脈瘤與動靜脈瘻管病灶的血流通道提供較正確診斷，另外有26%(9/34)的病人之彩色超音波比血管攝影顯示較清楚或正確的血流流向變化；這是因為彩色超音波可做重覆及多切面觀察，且在病人一般生理情況下進行掃描不受外力注射顯影劑影響，因此較血管攝影呈現更清楚與正確的診斷。總而言之，彩色杜普勒超音波是一種在病人生理的情況下、非侵襲性、無放射性且正確的下肢動脈疾病的診斷方法。

關鍵字

血管攝影，比較研究 ； 動脈，下肢 ； 動脈，狹窄或阻塞 ； 動靜脈畸形，下肢 ； 超音波，比較硏究 ； 超音波，杜普勒

並列摘要

Color Doppler ultrasound was performed in 35 patients with lower-extremity arterial disease including pseudoaneurysm, arteriovenous fistula, arteriovenous malformation, arterial stenosis and occlusion. All patients but one also received angiography. There were a total of 71 lesions among the 34 patients. Color mapping and Doppler spectrum showed specific findings in pseudoaneurysm, AV fistula and AV malformation. It directly and accurately evaluated the thrombus and severity of stenosis, and allowed marking on skin for lesions. Compared with angiography, the color Doppler ultrasound provides more informations including mural thrombus in 80%(41/51) of the cases of arterial stenosis and pseudoaneurysm, small flow channel in 44%( 8/18) of the cases of pseudoaneurysm and AV fistula, and change of flow direction in 26%(9/34) of the cases who had angiographic studies. The versatility of color Doppler ultrasound is that the scanning can be performed for usual physiological conditions with multiplanar capability without necessitating contrast injection. We conclude that, as compared with angiography, color Doppler ultrasound is a non-invasive, more physiological, effective and accurate means, without ionizing radiation, for evaluation of the arterial diseases in the lower extremity.

並列關鍵字

Angiography, comparative studies ； arteries, lower-extremities ； arteries, stenosis or occlusion ； arteriovenous malformation, lower-extremities ； ultrasound US, comparative studies ； ultrasound, Doppler studie