摘要：
Objective To discuss the value of color Doppler flow imaging (CDFI) in diagnosis of mesenteric vessel ischemia lesions.Methods The patients with suspected vascular abdominal pain (n=113) were given examinations of CDFI and multi-slice spiral computed tomography angiography (CTA), and the examination content included plaque, dissection and thrombus in arterial lumen for observing the characteristics of CDFI in arterial and nervous lumens. The peak systolic velocity (PSV) was detected in stenotic site, and spectrum signature of distal flow was observed. The sensitivity and specificity of CDFI, and Kappa value between CDFI and CTA were calculated by using SPSS 13.0 software, and truth and reliability of CDFI were reviewed.Results There were 24 patients with positive outcomes of CTA in definite diagnosis of mesenteric vessel ischemia lesions, and 89 with negative outcomes. There were 23 patients with positive CDFI outcomes and 90 with negative CDFI outcomes, including 13 with stenosis of superior mesenteric artery (SMA), 5 with thrombembolia, 3 with isolated dissection complicated by thrombus, 2 with thrombus of superior mesenteric vein (SMV), 5 with missed distal thrombembolia, 3 with missed distal isolated dissection, 4 with misdiagnosed SMA stenosis, and 3 with misdiagnosed distal thrombembolia. The sensitivity of CDFI was 66.67%, specificity was 92.13%, and Kappa value was 0.597 (95%CI: 0.413~0.781). Conclusion CDFI has higher diagnostic value to mesenteric vessel ischemia lesions, which can accurately reflect lesion position and severity, thrombus and dissection, and hemodynamic changes. It is important to the diagnosis and etiological screening of mesenteric vascular abdominal pain.%目的 探讨彩色多普勒超声在诊断肠系膜血管缺血性病变中的价值.方法 应用彩色多普勒超声(CDFI)及多排螺旋CT造影(CTA)对113例疑诊为腹部血管源性腹痛的患者进行检查,检查内容包括动脉管腔有无斑块、夹层、血栓等,观察动静脉管腔的彩色多普勒特征,测量狭窄处收缩期峰值速度,观察远段血流频谱特征;利用软件SPSS13.0计算CDFI检查诊断的灵敏度、特异度及其与CTA检查结果 的一致性,评价CDFI诊断的真实性及可靠性.结果 经CTA检查确诊肠系膜血管缺血性病变阳性患者为24例、阴性89例;CDFI检查阳性23例、阴性90例,包括肠系膜上动脉(SMA)狭窄13例,血栓栓塞5例,孤立性夹层并血栓3例,肠系膜上静脉(SMV)血栓2例,漏诊远段血栓栓塞5例,远段孤立性夹层3例,误诊SMA狭窄4例,远段血栓栓塞3例;CDFI检查诊断的灵敏度为66.67%,特异度为92.13%,Kappa值为0.597(95%CI:0.413~0.781).结论 CDFI检查对肠系膜血管缺血性病变具有较高的诊断价值,能够比较准确地显示病变的部位、程度、有无血栓和夹层,及血流动力学的改变,对肠系膜血管源性腹痛的诊断及病因筛选具有重要的临床意义.
