Doppler ultrasound

多普勒超声
  • 文章类型: Case Reports
    肱动脉末端分支的最大分支是尺动脉,出现在肘窝之后。该动脉通常在前臂前部的肌肉中具有较深的路径,并且负责前臂尺侧和手的近鱼际区域的浅表和深层肌肉组织的血管形成。我们报告了通过多普勒超声诊断出的解剖学变异,其中尺动脉在前臂中处于浅表位置。很少发生尺浅动脉,但这对临床医生来说是一个重要的事实,外科医生,和护理专业人员。
    The largest branch of the terminal division of the brachial artery is the ulnar artery, which arises after the cubital fossa. This artery usually has a deep path in the muscles of the anterior forearm and is responsible for vascularization of the superficial and deep musculature on the ulnar side of the forearm and hypothenar area of the hand. We report an anatomical variant diagnosed by Doppler ultrasound in which the ulnar artery had a superficial position in the forearm. Occurrence of a superficial ulnar artery is rare, but it is an important fact for clinicians, surgeons, and nursing professionals.
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  • 文章类型: Case Reports
    背景:静脉动脉瘤(VA)是非静脉曲张的局灶性扩张(与相邻的上游或下游静脉段相比,直径增加了至少1.5倍),当位于下肢的深静脉中时,以及当它影响肌肉筋膜上方的静脉时,它具有静脉血栓栓塞(VTE)的风险。
    方法:我们报告了一例40岁的女性,其右小腿上三分之一的肿块样病变表现为疼痛和致残。多普勒超声(DUS)检查显示小隐静脉(SSV)在隐pop交界处(SPJ)扩张并沿其整个长度形成血栓。开始抗凝治疗,但尽管血栓在DUS上消退,功能性阳痿和持续的疼痛促使SSV剥离。组织学允许诊断SSV的原发性动脉瘤。
    结论:大隐静脉的扩张段并不总是静脉曲张(VVs)。真正的VAs可以在位于肌肉筋膜上方的静脉上发展,像深层的VA,可能会触发VTE。小隐静脉动脉瘤很少有报道,只有少数临床观察描述了SSV动脉瘤的血栓形成。DUS应检查the窝或小腿上部的任何肿块,以寻找SSV动脉瘤。如果在诊断时存在血栓形成,建议切除隐静脉并结扎。
    BACKGROUND: A venous aneurysm (VA) is a focal dilatation of a nonvariceal vein (diameter increased by at least 1.5 times compared to the adjacent upstream or downstream venous segment), which carries a risk of venous thromboembolism (VTE) when located in the deep veins of the lower limbs but also when it affects the veins above the muscle fascia.
    METHODS: We report the case of a 40-year-old woman who presented with a painful and disabling mass-like lesion of the upper third of the right calf. A Doppler ultrasound (DUS) examination revealed a small saphenous vein (SSV) dilated at the saphenopopliteal junction (SPJ) and thrombosed along its entire length. Anticoagulant treatment was initiated but although the thrombosis regressed on DUS, the functional impotence and the persistence of pain prompted a stripping of the SSV. Histology allowed the diagnosis of SSV\'s primary aneurysm.
    CONCLUSIONS: Dilated segments of the saphenous vein are not always varicose veins (VVs). True VAs can develop on veins located above the muscular fascia and, like deep VAs, may trigger VTE. Small saphenous vein aneurysms have seldom been reported, and only a few clinical observations have described the thrombosis of a SSV aneurysm. Any mass in the popliteal fossa or upper part of the calf should be examined by DUS to look for an SSV aneurysm. Excision of the saphenous vein with junctional ligation is advised if thrombosis is present at the time of diagnosis.
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  • 文章类型: Case Reports
    May-Thurner综合征,也被称为髂静脉压迫综合征,是一种罕见的血管疾病,涉及右髂总动脉压迫左髂总静脉。这种压迫可导致静脉淤滞并增加左下肢深静脉血栓形成的风险。治疗选择范围从保守措施到血管内手术,如静脉支架置入术。这里,我们介绍了一名45岁的女性,她的左腿有反复的深静脉血栓形成史,他带着肿胀来到急诊室,疼痛,和温柔。她正在接受华法林治疗以治疗深静脉血栓。体格检查和实验室检查支持急性深静脉血栓形成的诊断。进一步的调查显示梅-瑟纳综合征,左髂总静脉被右髂总动脉压迫,导致左下肢广泛的血栓形成。进行血管内支架置入术以缓解阻塞并恢复静脉血流。患者的症状在支架置入手术后得到改善,在继续抗凝治疗的随访期间,她仍然无症状。对梅-瑟纳综合征的认识至关重要,尤其是在有复发性深静脉血栓形成和解剖学危险因素的患者中。成功的管理需要涉及抗凝治疗和血管内支架置入的多学科方法。
    May-Thurner syndrome, also known as iliocaval compression syndrome, is a rare vascular condition that involves compression of the left common iliac vein by the right common iliac artery. This compression can lead to venous stasis and increase the risk of deep vein thrombosis in the left lower extremity. Treatment options range from conservative measures to endovascular procedures such as venous stenting. Here, we present the case of a 45-year-old female with a history of recurrent deep vein thrombosis in her left leg, who arrived at the emergency department with swelling, pain, and tenderness. She was on warfarin therapy for deep vein thrombosis management. Physical examination and laboratory investigations supported the diagnosis of acute deep vein thrombosis. Further investigations revealed May-Thurner syndrome, with the left common iliac vein being compressed by the right common iliac artery, leading to extensive thrombosis in the left lower extremity. Endovascular stenting was performed to relieve the obstruction and restore venous blood flow. The patient\'s symptoms improved after the stenting procedure, and she remained asymptomatic during follow-up with continued anticoagulation therapy. Awareness of May-Thurner syndrome is crucial, especially in patients with recurrent deep venous thrombosis and anatomical risk factors. Successful management requires a multidisciplinary approach involving anticoagulation therapy and endovascular stenting.
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  • 文章类型: Case Reports
    胸出口综合征是一种罕见的神经血管疾病,通常是由颈肋骨或肥大的肌对锁骨下血管和/或臂丛神经的压迫引起的。当锁骨下动脉受压时,它可以导致灌注不足,发紫和上肢更大的疲劳;如果锁骨下静脉被压缩,它可以引起静脉充血,上肢肿胀和疼痛。当压迫影响臂丛时,它可引起上肢刺痛或感觉异常。它可以是单声道或双边的,先天性,或获得。由于罕见,血管改变的诊断很困难,知识贫乏,和症状的非特异性。超声允许定位和测量血管狭窄程度。未能诊断会使患者面临严重的健康风险。我们描述了一种罕见的由前斜角肌肥大引起的静脉压迫病例。
    Thoracic outlet syndrome is a rare neurovascular disease, usually caused by compression of subclavian vessels and/or brachial plexus by a cervical rib or hypertrophic scalene muscles. When the subclavian artery is compressed, it can cause perfusion deficiency with cyanosis and greater fatigue of the upper limb; if the subclavian vein is compressed, it can cause venous congestion with swelling and pain in the upper limb. When compression affects the brachial plexus, it can cause tingling or paresthesia of the upper limb. It can be mono or bilateral, congenital, or acquired. The diagnosis of vascular alterations is difficult due to the rarity, poor knowledge, and nonspecificity of symptoms. Ultrasound allows to localize and measure the vascular stenosis degree. Failure to diagnose can expose patients to serious health risks. We describe a rare case of venous compression caused by anterior scalene muscle hypertrophy.
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  • 文章类型: Case Reports
    胎盘绒毛膜血管瘤是最常见的胎盘良性肿瘤。然而,临床上明显的绒毛膜血管瘤并不常见,发病率介于1:3,500和1:9,000之间.在大多数情况下,它是小的或微观的,没有临床意义。如果尺寸增加超过5厘米,那么它可能与严重的母体并发症有关,如镜像综合征,羊水过多,先兆子痫,产前出血,早产和分娩,产后出血,以及胎儿并发症,如胎儿贫血,胎儿血小板减少症,胎儿水肿,宫内生长受限,胎儿死亡,新生儿死亡。与羊水过多相关的巨大绒毛膜血管瘤导致高围产期发病率和死亡率。在胎儿存活之前有并发症的绒毛膜血管瘤需要干预。在选择性病例中,可以考虑保守管理和密切监测。我们报告了一例巨大的胎盘绒毛膜血管瘤,并发严重的羊水过多,保守治疗,母婴结局良好。
    Placental chorioangioma is the most common benign tumor of the placenta. However, clinically evident chorioangiomas are less common with an incidence ranging between 1:3,500 and 1:9,000 births. In the majority of cases, it is small or microscopic and of no clinical significance. If it increases more than 5 cm in size, then it may be associated with serious maternal complications such as mirror syndrome, polyhydramnios, preeclampsia, antepartum hemorrhage, preterm labor and delivery, and postpartum hemorrhage, as well as fetal complications such as fetal anemia, fetal thrombocytopenia, fetal hydrops, intrauterine growth restriction, fetal demise, and neonatal death. Giant chorioangioma associated with polyhydramnios leads to high perinatal morbidity and mortality. Chorioangioma with complications before fetal viability needs interventions. Conservative management with close surveillance can be considered in selective cases. We report a case of giant placental chorioangioma complicated with severe polyhydramnios managed conservatively with favorable maternal and fetal outcomes.
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  • 文章类型: Case Reports
    主动脉缩窄是一种严重的病理,在儿科患者中可能被低估。我们介绍了1例急诊诊断为主动脉缩窄的患者,由他的主治医生在检测高血压数字时转诊。这项研究的重点是诊断方法和多普勒超声检查结果。
    Aortic coarctation is a severe pathology that can be underdiagnosed in pediatric patients. We present 1 case of a patient diagnosed with aortic coarctation in the emergency department, referred by his treating physician when detecting high blood pressure figures. This study focuses on the diagnostic approach and Doppler ultrasound findings.
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  • 文章类型: Journal Article
    背景:获得性子宫AVM是子宫动脉和静脉之间的异常和非功能性连接。据报道,这是刮宫手术子宫外伤的结果,骨盆手术。
    方法:作者报告2例吸刮术后子宫AVM在此病的常规随访中在超声筛查中偶然发现的磨牙妊娠。在卡萨布兰卡母婴大学医院AbderrahimHarouchi的妇产部诊断。
    子宫AVM极为罕见,在重度和持续性子宫出血的情况下应考虑。子宫AVM要么是获得性的,很少,先天性,由于胚胎发生过程中初级血管结构的异常分化。当栓塞可能作为治疗选择时,侵入性技术可以确认主要供血血管的诊断和识别。
    结论:获得性子宫动静脉畸形是子宫外伤的结果;它表现为阴道子宫出血,可能危及生命,这种情况的罕见使其难以诊断,然而,调查技术的发展有助于诊断过程。
    BACKGROUND: Acquired uterine AVM is an abnormal and non-functional connection between uterine arteries and veins. It is reported as a consequence of uterine trauma as curettage procedures, pelvic surgery.
    METHODS: The authors report 2 cases of uterine AVM post suction-curettage procedure on molar pregnancy incidentally discovered in ultrasound screening in the usual follow-up of this disease, diagnosed in the Department of Maternity of Mother and Child University Hospital Abderrahim Harouchi of Casablanca.
    UNASSIGNED: Uterine AVMs are extremely rare and should be considered in cases of heavy and persistent uterine bleeding. Uterine AVMs are either acquired or, more rarely, congenital, due to abnormal differentiation of the primary vascular structures during embryogenesis. The invasive technique allows confirmation of the diagnosis and identification of the major feeding vessels when embolization may be indicated as a treatment option.
    CONCLUSIONS: Acquired uterine arteriovenous malformation is the result of uterine trauma; it presents as uterine bleeding through the vagina that can be life threatening, the rarity of the condition makes it difficult to diagnose, however the evolution of investigative techniques helps in the diagnostic process.
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  • 文章类型: Case Reports
    胆总管囊肿是罕见的先天性胆树囊性扩张。它们最常见于女婴和幼儿,和他们的病理仍不清楚。间歇性黄疸的三联征,腹部肿块,疼痛只在少数病人身上出现。准确的胆道解剖结构的诊断和勾画对于手术计划至关重要。这通常是通过超声和磁共振胰胆管造影成功实现的。最终的治疗方法是囊肿切除术,可降低胆道癌的风险。我们介绍了一个青春期男孩的胆总管囊肿的不寻常病例,并回顾了文献并强调了多种成像方式,包括肝脏特异性钆造影剂在具有挑战性的病例中的作用,以确认诊断。
    Choledochal cysts are rare congenital cystic dilatations of the biliary tree. They are most commonly present in female infants and young children, and their pathology remains unclear. The triad of intermittent jaundice, abdominal mass, and pain is found only in a minority of patients. Diagnosis and delineation of accurate biliary anatomy are crucial for surgical planning. This is most often successfully achieved with ultrasound and magnetic resonance cholangiopancreatography. The definitive treatment is cyst excision which decreases the risk of biliary carcinoma. We present an unusual case of a choledochal cyst in an adolescent boy with a review of the literature and emphasis on multi-imaging modalities, including the role of liver-specific gadolinium contrast agents in challenging cases to confirm the diagnosis.
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  • 文章类型: Case Reports
    肝动脉血管痉挛可能是肝移植后潜在的血管并发症,可表现为肝动脉血栓形成。由于这种病理学的文献很少,它的发病率,机制,相关性,诊断,和预后仍有待研究。我们的索引案例,一名64岁的男子患有与酒精相关的失代偿性肝硬化,接受尸体原位肝移植,术后病程正常。术后第12天,肝酶升高,多普勒超声检查显示肝动脉闭塞。针对肝动脉血栓形成进行数字减影血管造影(DSA),显示移植肝动脉的串珠外观,肝动脉吻合口无血栓形成或狭窄。它是通过口服血管扩张剂来管理的,以及通过放置在肝动脉中的DSA导管尖端动脉内施用血管扩张剂。他对管理反应良好,并在术后第24天出院,肝酶正常。
    Hepatic arterial vasospasm can be a potential vascular complication after liver transplantation and can manifest as hepatic artery thrombosis. Due to the scarcity of literature on this pathology, its incidence, mechanism, relevance, diagnosis, and prognosis remain to be investigated. Our index case, a 64-year-old man with decompensated alcohol-related cirrhosis, underwent a cadaveric orthotopic liver transplant and was having a normal postoperative course. On postoperative day 12, liver enzymes were elevated, and Doppler ultrasound performed showed hepatic arterial occlusion. In view of hepatic artery thrombosis digital subtraction angiography (DSA) was done, which showed a string bead appearance of graft hepatic artery, with no thrombosis or stenosis of hepatic artery anastomosis. It was managed by oral administration of vasodilator, as well as intra-arterial administration of vasodilators through DSA catheter tip placed in the hepatic artery. He responded well to the management and was discharged on postoperative day 24 with normal liver enzymes.
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  • 文章类型: Case Reports
    由于剖宫产次数过多,胎盘植入谱系障碍(PAS)的发生频率增加。与胎盘保留相关的异常胎盘可导致持续的子宫出血,超声多普勒检查是评估子宫出血的主要选择。获得性子宫动静脉畸形(AVM)可能是由于子宫外伤而发生的,自然流产,扩张和刮宫,子宫内膜癌或妊娠滋养细胞疾病。与AVM相关的异常胎盘形成的治疗可以是保守的,以甲氨蝶呤治疗为代表,动脉栓塞,刮宫术,宫腔镜环形切除术或根治性切除术,考虑到全子宫切除术。治疗管理总是考虑胎盘侵袭的程度,患者血流动力学状态及生育力保存。考虑到所描述的方面,我们介绍了一例与获得性子宫AVM相关的胎盘保留的病例,具有想象和临床特征,提示妊娠滋养细胞疾病,通过子宫切除术成功治疗,以及对文献的小评论,因为只有少数出版物报道了类似的诊断和治疗关联。
    Placenta accreta spectrum disorder (PAS) has an increased frequency due to the high number of cesarean sections. The abnormal placentation associated with a retained placenta can cause persistent uterine bleeding, with ultrasound Doppler examination being the main choice to assess the uterine hemorrhage. An acquired uterine arteriovenous malformation (AVM) may occur because of uterine trauma, spontaneous abortion, dilation and curettage, endometrial carcinoma or gestational trophoblastic disease. The treatment for abnormal placentation associated with AVM can be conservative, represented by methotrexate therapy, arterial embolization, uterine curettage, hysteroscopic loop resection or radical, which takes into consideration total hysterectomy. Therapeutic management always considers the degree of placental invasion, the patient hemodynamic state and fertility preservation. Considering the aspects described, we present a case of retained placenta percreta associated with acquired uterine AVM, with imagistic and clinical features suggestive of a gestational trophoblastic disease, successfully treated by hysterectomy, along with a small review of the literature, as only a few publications have reported a similar association of diagnostics and therapy.
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