周圍血管疾病超聲診斷英文

PeripheralVascular

Ultrasound5/8/20241周圍血管疾病超聲診斷英文PARTⅠAneurysm（動脈瘤）5/8/20242周圍血管疾病超聲診斷英文Aneurysm（動脈瘤）TrueAneurysmFalseAneurysmDissectiveAneurysmAneurysmsdevelopasthestructuralintegrityofthearterialwallweakens.5/8/20243周圍血管疾病超聲診斷英文A:fusiform;B:tortuouselongated;C:saccular;D:infrarenal;E:suprarenal;FandG:dissecting;I:Falseaneurysm.Aneurysmsdevelopasthestructuralintegrityofthearterialwallweakens.Aneurysmsareveryvariableinshapes5/8/20244周圍血管疾病超聲診斷英文TrueAneurysmItisabnormaldilationsofarterieshavingatleasta50%increaseindiametercomparedtothenormaldiameter.Itisoftencausedbyarteriosclerosis.Itisthecommontypeinaneurysms.5/8/20245周圍血管疾病超聲診斷英文Ultrasoundfindings--1①Thearteryisdilatedlocally.Thewidthofdilatedsegmentis1.5timeswiderthanthatofnormalsegment.②Mostaneurysmsarefusiforminshape③Thethreelayersofarterialwallcanbeseen.5/8/20246周圍血管疾病超聲診斷英文Theabdominalaortaisdilatedlocally.Itmeasures51mmintheanteroposteriordimension.Thedistalnormalarterymeasures20mmindiameter.ABC5/8/20247周圍血管疾病超聲診斷英文④Thrombuscanusuallybeseeninarterialcavity.⑤CDFIshowsswirlingbloodflowpattern.5/8/20248周圍血管疾病超聲診斷英文Bothtransverseandsagittalimagesshowafusiformaneurysmwithalargeamountofthrombusinthearterialwalls5/8/20249周圍血管疾病超聲診斷英文DissectiveAneurysmDissectingananeurysmcanoccurduetoatearintheintimaandbloodcanenterthesubintimalspace.Iftheaortapartiallydissects,largeamountsofthrombusmaybeseeninthesubintimalspace.Ifthereisafulldissection,afalseflowlumeniscreated.5/8/202410周圍血管疾病超聲診斷英文Ultrasoundfindings①Thetearing

of

intimacanbeseen;②Thetrueandfalselumenscanbeseen;buttheentryisdifficulttobedetected③Thrombuscanbeseeninfalselumen;④Bloodflowsmayappearinfalselumen.Butitislessbrighterandlowvelocitycomparedwiththatintruelumen.5/8/202411周圍血管疾病超聲診斷英文Bothlongitudinalandtransverseimagesshowthetearing

of

intimainanexternalcarotidartery5/8/202412周圍血管疾病超聲診斷英文B-modeimageofadissectingaorticaneurysm.thetrueandfalselumensareseen.Colorflowimagingdemonstratesflowinthefalselumen.5/8/202413周圍血管疾病超聲診斷英文FalseAneurysmItisoftencausedbytrauma,angiographyorsurgeryafterarterypuncture.Bloodcontinuestoflowbackwardandforwardthroughthepuncturesiteintoafalseflowcavityoutsidetheartery.Thewallofaneurysmismadeupofhematomaandsurroundingcompressedtissue.5/8/202414周圍血管疾病超聲診斷英文Ultrasoundfindings①Amixedorcysticmasscanbeseenbythesideofartery;②Sometimesanarrowroutefromarterytothemasscanbeimaged;③Thrombuscanbeseenwithinthemass;④

CDFI:thebloodflowwithinthemassiseddiedflow.5/8/202415周圍血管疾病超聲診斷英文Systolicanddiastolicimagesoffalseaneurysm:A:swirlingmotionofblood;B:asmallchannel.C:theclassicto-and-frowaveformABC5/8/202416周圍血管疾病超聲診斷英文classicto-and-frowaveform5/8/202417周圍血管疾病超聲診斷英文Aneurysm（動脈瘤）Aneurysm（動脈瘤）5/8/202418周圍血管疾病超聲診斷英文PARTⅡArterioscleroticOcclusiveDisease（動脈硬化性閉塞性疾?。?ASO)5/8/202419周圍血管疾病超聲診斷英文5/8/202420周圍血管疾病超聲診斷英文Itisduetoarteriosclerosis.Itoftenoccursatlarge-mediumsizedarteriesintheelderly.SeveralriskfactorsareassociatedwithASO:increasingagehypertensiondiabeteselevatedcholesteroltobaccosmokingafamilyhistoryofatherosclerosis5/8/202421周圍血管疾病超聲診斷英文Injurytothevascularendotheliumprogressivedepositionoflipids,proliferationofsmoothmusclecells,andmigrationoffibrocytesplaqueformingandgrowingvascularstenosis(狹窄)orocclusion5/8/202422周圍血管疾病超聲診斷英文PlaqueCharacterizationPlaqueisusuallydescribedbysurfacefeature,density,andtexture.Surfacefeaturesaresmooth,irregular,andulcerated.Hypoechoic,isoechoic,andhyperechoicarethetermsusedtodescribeplaquedensity.Plaquetextureiseitherhomogeneousorheterogeneous.5/8/202423周圍血管疾病超聲診斷英文AnechoicplaqueHypoechoicplaqueCalcifiedplaqueHyperechoicplaque5/8/202424周圍血管疾病超聲診斷英文A:acratersuggestinganulcerB:heterogeneous---intraplaquehemorrhageAB5/8/202425周圍血管疾病超聲診斷英文bloodflowsintoulceratedplaques(hyperechoicandhypoechoicheterogeneous)5/8/202426周圍血管疾病超聲診斷英文CDFI:narrowbloodstreammeansarterialstenosisPW:

high

speedwaveand

widefrequency

band5/8/202427周圍血管疾病超聲診斷英文2D:theplaquemakesthearterystenosisCDFI:thenarrowmulticoloured

jetbloodflow

signalsthroughstenosisPW:highspeedflowwithwidefrequency

band5/8/202428周圍血管疾病超聲診斷英文PARTⅢDeepVeinThrombosis深靜脈血栓

(DVT)5/8/202429周圍血管疾病超聲診斷英文DVTisacommondisorderthatcanleadtofatalpulmonaryembolism.DVTusuallyaffectsthelowerlimbveins,especiallyduetotrauma,surgery,pregnancyormalignancy.EpidemiologyandPathology5/8/202430周圍血管疾病超聲診斷英文Typicalsymptomsincludepain,tenderness,heatandswelling.Butthesesignsarenonspecificandcanbecausedbyseverallocalorsystemicconditions.Thesuperficialveinsmaybedilated.IftheDVTinvolvestheproximalveins,theremaybesignificantswellingofthethigh.SignsandSymptoms5/8/202431周圍血管疾病超聲診斷英文Acutethrombus(within2weeks)Sub-acutethrombus(morethantwoweeks)Chronicthrombus(severalmonthstoyears)UltrasoundFindingsThedistinctionbetweenacuteandchronicDVTisdifficultonallimagingmodalities5/8/202432周圍血管疾病超聲診斷英文Theveinisenlargedobviously;compressingactioncannotmakethecavityshrunken;Theinternalechoesofcavityareecho-freeorhypoechoic;Nobloodflowswithcompletethrombosis.1.AcuteThrombus5/8/202433周圍血管疾病超聲診斷英文Thedeepveinsofthelowerextremityarefilledanddistendedbyacutehypoechoicthrombus5/8/202434周圍血管疾病超聲診斷英文Theacutehypoechoicthrombusfillinganddistendingdeepveindoesnotcompress5/8/202435周圍血管疾病超聲診斷英文Thesizeofcavitymaybecomenormal;TheinternalechoesofDVTincrease;There-openingmayoccurandCDFIcanshowbloodflowindifferentshapesinthecavity.2.Sub-acutethrombus5/8/202436周圍血管疾病超聲診斷英文A--athrombusaroundjugularveincatheter.

B--CDFIshowsancolorvoidordefect.BA5/8/202437周圍血管疾病超聲診斷英文Theyappearmoreechogenicthanacuteclots;Thewallisthickened,irregular,echogenic,theveinisincompletelycompressible;CDFIshowbloodflowsincavitywhencompleteorpartialre-openingoccurs.3.Chronicthrombus5/8/202438周圍血管疾病超聲診斷英文A---anacutethrombusdistendingthevein.

B---

partialrecanalizationwithchronicDVTremainingafter2months.AB5/8/202439周圍血管疾病超聲診斷英文PWshowsstraightwaveoflowerlimbveinswithnoresponsetoValsalvaorrespiration.Itindicatesamoreproximalobstruction.5/8/202440周圍血管疾病超聲診斷英文VenousInsufficiencyVeinscontainvalvestopreventtherefluxofbloodtotheextremities.Venousinsufficiencyoccurswhenthelowerextremityvenousvalvesaredestroyedorbecomeincompetent.5/8/202441周圍血管疾病超聲診斷英文ChronicvenousinsufficiencyiscausedbyvalvulardamagefollowingDVTinabout40%ofindividuals.However,theother60%ofpatientswithvenousinsufficiencyhaveincompetentvalves,unrelatedtoDVT.Pathophysiology5/8/202442周圍血管疾病超聲診斷英文Clinically,venousinsufficiencyleadstolegswelling,chronicskinchangessuchaseczema,pigmentation,woodyindurationandnonhealingvenousstasisulcersfinally.SignsandSymptomsSuperficialvenousinsufficiencyleadstodistendedsubcutaneousvaricosities.5/8/202443周圍血管疾病超聲診斷英文Subcutaneousvaricosities.CDFI:retrogradeflowduringaValsalvaactionorfollowingdistalsqueezerelease.PW:refluxwave(refluxduration>1s).Thedegreeofrefluxisassessedbyrefluxd