彩色多普勒超声结合超声造影评估主动脉夹层TEVAR介入术后血管重塑

发布时间：2018-09-12 19:55

【摘要】：目的应用彩色多普勒超声及主动脉超声造影观察De Bakey III型主动脉夹层(AD)腔内隔绝术(TEVAR)前后腹段血管,探讨术后血管重塑及血流动力学变化,为临床治疗提供除主动脉CT血管成像(CTA)以外的影像学评估手段。资料与方法选取30例Debakey III型AD患者,于术前、术后1 d及术后1个月采用彩色多普勒超声结合超声造影检查其腹段血管,动态观察真假腔大小、血流动力学特征、假腔内血栓化程度、远端破口及重要器官血供,结合CTA结果综合分析。结果腹段血管TEVAR术后1 d和术后1个月真腔内径、最大流速均较术前明显增大(P0.05);假腔内径、最大流速均较术前明显减小(P0.05);受累器官血供术前与术后近期比较变化差异无统计学意义(均P0.05),且内径测值与CTA差异亦无统计学意义(P0.05)。结论彩色多普勒超声结合超声造影从血流动力学及形态学评估De Bakey III型AD TEVAR术后血管重塑简单易行,重复性好,可弥补既往单从形态学上评估的不足。
[Abstract]:Objective to investigate the changes of vascular remodeling and hemodynamics of De Bakey III type aortic dissection before and after (TEVAR) by using color Doppler ultrasound and aortic contrast echocardiography. To provide clinical treatment in addition to aortic CT angiography (CTA) imaging evaluation methods. Materials and methods 30 patients with Debakey III type AD were examined by color Doppler ultrasound and contrast-enhanced ultrasonography before operation, 1 day after operation and 1 month after operation. The true and false cavity size and hemodynamic characteristics were observed dynamically. The degree of pseudo-lumen thrombus, distal rupture and blood supply of important organs were analyzed in combination with CTA results. Results the true lumen diameter and maximum velocity of abdominal vascular TEVAR were significantly increased 1 day after operation and 1 month after operation (P0.05). The maximum velocity of blood flow was significantly decreased compared with pre-operation (P0.05); the blood supply of affected organs had no significant difference between pre-operation and post-operation (P0.05), and there was no significant difference between the measured value of internal diameter and CTA (P0.05). Conclusion it is simple and reproducible to evaluate vascular remodeling after De Bakey III type AD TEVAR by color Doppler ultrasound combined with contrast-enhanced ultrasonography from hemodynamics and morphology, which can make up for the shortage of morphological evaluation in the past.
【作者单位】：东莞康华医院心内科;
【基金】：广东省东莞市重点社会科技发展项目(201450725000097)
【分类号】：R445.1;R543.1

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