彩色都卜勒超音波在周邊血管假性血管瘤的應用

The Application of Color Doppler Ultrasound on Hemodialysis Patients before PTA

黃德利(De-Li Huang) ； 楊金鳳(Chin-Feng Yang) ； 林承萱(Cherng-Shiuan Lin) ； 陳嬿如(Yen-Ju Chen) ； 黃碧怡(Pi-Yi Huang) ； 吳碧珠(Pi-Chu Wu) ； 楊以玲(Yi-Ling Yang) ； 梁慧隆(Huei-Lung Liang)

《中華放射線技術學雜誌》 31卷2期 (2007/12) Pp. 129-136

https://doi.org/10.30045/CJRT.200712.0007

摘要

本研究以彩色都卜勒超音波(color Doppler ultrasound, CDU)針對洗腎病人功能性不良的血管通路，評估病人血管通路之狹窄、阻塞和回流靜脈等相關訊息，幫助放射科醫師在實施血管形成術(percutaneous transluminal angioplasty, PTA)時選擇最佳的進針點和疏通方式，以節省血管形成術的時間和提高治療的成功率。本研究共收集了250位洗腎病人在做血管形成術治療前彩色都卜勒超音波影像，將超音波影像和血管攝影影像對照。利用血管攝影爲黃金標準(gold standard)評估彩色都卜勒超音波，正確者有240位(96%)，不正確者有10位(4%)。另以血管形成術治療實際進針點爲黃金標準，比較彩色都卜勒超音波對最佳進針點建議的一致性。其建議最佳進針點一致者有236 位(94.4%)、需再另一處進針輔助者有14位(5.6%)。彩色都卜勒超音波可以準確地評估洗腎病人周邊血管通路的實際狀況，因此，於術前提供了實質有用、有價值的資訊，使在血管形成術治療時，能選擇最佳的進針點和最適宜的疏通方式，縮短做血管形成術的時間並提高治療的成功率。

關鍵字

彩色都卜勒超音波 ； 洗腎 ； 血管形成術 ； 血管通路 ； 血管攝影

並列摘要

We used color Doppler ultrasound (CDU) to evaluate a dysfunctional vascular access in hemodialysis patients before percutaneous transluminal angioplasty (PTA). With the knowledge of vascular lesions in the vascular access (including vascular stenosis/occlusion in arterio-venous anastomosis and/or outflow vein), interventional radiologists may chooses the best puncture site for the later percutaneous restoration with less procedure time and higher treatment success rate. A total of 250 hemodialysis patients with color Doppler ultrasound images of their dysfunctional vascular accesses before PTA treatment were enrolled in this study. Used angiography as the gold standard, we measured the diagnostic accuracy of color Doppler ultrasound on vascular access in hemodialysis patients. In our study the accuracy was achieved in 240 patients (96%), whereas the inaccuracy in 10 patients (4%). The actual puncture site adopted for PTA was the same with those recommended by color Doppler ultrasound study in 236 patients (94.4%). Another puncture site required to complete the PTA was found in 14 patients (5.6%). In conclusion CDU was considered as an easy technique to accurately evaluate the dysfunctional vascular access in hemodialysis patients. It provided essential and valuable information to interventional radiologists to choose the best puncture site for PTA, in addition, saved the procedural time and enhances the treatment success rate.

並列關鍵字

color Doppler ultrasound ； hemodialysis ； percutaneous transluminal angioplasty ； vascular access ； angiography