摘要
目的 分析头皮动静脉畸形的二维超声及多普勒频谱特点 ,评价其超声诊断价值。方法 对 9例头皮动静脉畸形患者 ,使用高频超声探测病变部位及两侧颞浅动脉、枕动脉 ,测量病变血管的内径、收缩期峰值流速 (Vmax)、舒张末血流速度 (Vmin)及阻力指数 (RI)。与脑血管造影结果及 40例健康志愿者颞浅动脉、枕动脉多普勒频谱参数进行对比分析。结果 超声表现为病变区域头皮下形态不规则的低回声或无回声区 ,内呈网格状或蜂窝样无回声 ;无回声区内血流异常丰富 ,充满闪烁明亮的五彩镶嵌状血流信号 ;病变内部多普勒频谱表现为高速低阻的动脉样血流频谱 ,Vmax为 (77.7± 14 .3 )cm /s ,Vmin为 (4 4.3± 5 .7)cm /s ,RI为 (0 .41± 0 .0 9) ;检出供血动脉 16支 ,频谱形态为高速低阻型。与正常对照组相比 ,病变血管内径、Vmax及Vmin显著增大 ,RI明显降低 (P <0 .0 0 1) ;引流静脉血流速度加快 ,呈现脉动样低阻力型频谱形态。结论 头皮动静脉畸形的超声表现符合其病理改变及高血流病变的高流速低阻力的血流动力学特点 ,易与缓流病变头皮海绵状血管瘤的超声图像相鉴别。
Objective To analyze the ultrasonographic characters in the patients with scalp arteriovenous malformations and evaluate the value of ultrasonography in the diagnosis.Methods The head soft tissue mass,bilateral superficial temporal artery and occipital artery in 9 patients with scalp arteriovenous malformations were examined using high frequency ultrasound.The caliber,systole peak velocity(Vmax),diastole end velocity(Vmin) and resistance index(RI) of the abnormal vessels were recorded.The findings were compared and analyzed with those of the cerebral angiography and ultrasonography in 40 healthy volunteers.Results These lesions displayed subcutaneous hypoecho or no echo region full of reticular or honeycombed darkspace by two dimensional ultrasound,rich signals with flickering and bright mosaic flow by color Doppler and the spectra of high velocity and low resistance by pulsed Doppler.Arterial spectral shape with high velocity and low resistance were found within the lesions and Vmax( 77.7 ± 14.3 ) cm/s,Vmin( 44.3 ± 5.7 )cm/s,RI= 0.41 ± 0.09 .Sixteen feeding arteries with spectra of high velocity and low resistance were checked out,their caliber,Vmax and Vmin were higher and RI lower significantly than those in the control (P< 0.001 ).The draining venous velocities increased and their spectral waveforms were pulsatile and low resistant.Conclusions The ultrasonic imaging of scalp arteriovenous malformations accords with its pathologic manifestation and the high velocity,low resistant hemodynamic changing of the high flow lesion.So they can be differentiated from cavernous hemangioma of the scalp by ultrasonography,which features with low flow lesion.Ultrasonography provides a valuable means to diagnose this disease.
出处
《中华超声影像学杂志》
CSCD
2004年第9期687-690,共4页
Chinese Journal of Ultrasonography
