Cronan J J, Murphy T P
Department of Diagnostic Imaging, Rhode Island Hospital, and Brown University School of Medicine, Providence 02903.
J Intensive Care Med. 1993 Jul-Aug;8(4):188-201. doi: 10.1177/088506669300800404.
Ultrasound has an increasingly important role in evaluation of the vascular system. Ultrasound is especially useful for intensive care patients because of the frequency of vascular complications developing in the ICU setting, as well as the ability of ultrasound to be performed at the patient's bedside. Ultrasound is the method of choice for evaluation of deep vein thromboembolic disease of the lower extremity in all patients; it demonstrates excellent sensitivity and specificity for this condition. It should also be the initial method of evaluation of upper extremity deep vein thrombosis. However, ultrasound may be limited in this assessment due to lack of reliably demonstrating the central subclavian and innominate veins, and therefore may be inadequate for evaluation of malfunctioning central venous catheters. Ultrasound can reliably identify and potentially be used to treat arterial complications of arterial catheterization, such as pseudoaneurysms. Similarly, ultrasound is accurate in the diagnosis of the presence of abdominal aortic aneurysm, and ultrasound can be used to assess carotid and lower extremity arteries noninvasively. Finally, ultrasound is useful for evaluation of hemodialysis fistulas and vascular complications of transplants.
超声在血管系统评估中发挥着越来越重要的作用。由于重症监护病房（ICU）环境中血管并发症的发生率较高，以及超声能够在患者床边进行检查，因此超声对重症监护患者特别有用。超声是所有患者下肢深静脉血栓栓塞性疾病评估的首选方法；它对这种疾病具有出色的敏感性和特异性。它也应该是上肢深静脉血栓形成评估的初始方法。然而，由于无法可靠地显示锁骨下静脉和无名静脉，超声在这种评估中可能会受到限制，因此可能不足以评估中心静脉导管功能异常。超声能够可靠地识别并有可能用于治疗动脉导管插入术的动脉并发症，如假性动脉瘤。同样，超声在腹主动脉瘤存在的诊断中很准确，并且超声可用于无创评估颈动脉和下肢动脉。最后，超声对于评估血液透析瘘和移植血管并发症很有用。
