彩色多普勒超声诊断中弓韧带压迫综合征

发布时间：2018-02-12 09:20

  本文关键词： 腹腔动脉 中弓韧带压迫综合征 超声检查 多普勒 彩色　出处：《中国医学影像技术》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨彩色多普勒超声诊断中弓韧带压迫综合征(MALS)的价值。方法采用彩色多普勒超声对41例腹痛患者的腹腔动脉进行筛查,观察腹腔干起始段走行、管腔内径,再分别测量起始段狭窄处平静状态、深吸气末、深呼气末收缩期峰值速度(PSV_(calm)、PSV_(insp)、PSV_(exp)),并计算深呼气末与深吸气末血流速度变化率(流速变化率)。对照组为100例接受腹部超声检查的无腹痛患者,分别测量上述各参数,比较MALS患者(MALS组)和对照组各参数的差异。以CTA结果为金标准,构建ROC曲线分析PSV_(exp)、流速变化率以及两者联合诊断MALS的价值。结果彩色多普勒超声共检出20例MALS,CTA检出19例。超声诊断MALS的敏感度为89.47%(17/19)、特异度为86.36%(19/22)、准确率为87.80%(36/41)、阳性预测值为85.00%(17/20)。MALS组腹腔干起始段血流峰值速度及流速变化率明显高于对照组(P均0.01)。PSV_(exp)、流速变化率的ROC曲线下面积分别为0.936、0.920(P0.01)。以PSV_(Exp)=330cm/s为阈值,诊断MALS的敏感度和特异度分别为85.7%和90.9%。当流速变化率=120%时,诊断MALS的敏感度和特异度分别为87.7%和89.4%。结论彩色多普勒超声可清晰显示腹腔干狭窄的部位、狭窄程度;将PSV_(exp)≥330cm/s或流速变化率≥120%或两者联合作为超声参考指标评估MALS,均有较高的诊断价值,且两者联合诊断的特异度最高。
[Abstract]:Objective to evaluate the value of color Doppler ultrasonography in diagnosis of medial arcuate ligament compression syndrome (MALSs). Methods 41 patients with abdominal pain were screened by color Doppler ultrasound, and the initial segment of abdominal trunk and the diameter of the lumen were observed. And then measure the quiet state of the narrow area of the starting section, and the deep inspiratory end, The peak systolic velocity of deep end expiratory period (PSV) was measured by the peak systolic velocity of PSV. The change rate of blood flow velocity at the end of deep expiratory and deep inspiratory was calculated. The control group consisted of 100 patients without abdominal pain who were examined by abdominal ultrasound, and the above parameters were measured separately. To compare the difference of the parameters between the MALS patients and the control group. The results of CTA were taken as the gold standard. The ROC curve was constructed to analyze the value of the two methods in the diagnosis of MALS. Results the color Doppler ultrasound detected 19 cases of MALS-CTA in 20 cases. The sensitivity of ultrasonic diagnosis of MALS was 89.4747 / 17 / 19, the specificity was 86.3636 / 1922%, the accuracy rate was 87.803636 / 41%, and the positive pre-diagnosis was positive. The changes of peak velocity and velocity of blood flow in the initial stage of celiac trunk in the group of 17 / 20g 路mals were significantly higher than those in the control group (P = 0.01). The area under the ROC curve of the velocity change rate was 0.936 ~ 0.920 / P0.01a, respectively. The threshold value of PSV_(Exp)=330cm/s was taken as the threshold. The sensitivity and specificity of the diagnosis of MALS were 85.7% and 90.9.The sensitivity and specificity of diagnosing MALS were 87.7% and 89.4when the velocity change rate was 120.Conclusion Color Doppler ultrasound can clearly show the stenoses of the celiac trunk and the degree of stenosis. Using PSV / s 鈮，

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