Yuan A, Yang P C, Lee L, Wu H D, Kuo S H, Luh K T, Chen W J, Lin F Y
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Ultrasound Med Biol. 2000 Jan;26(1):49-56. doi: 10.1016/s0301-5629(99)00118-0.
A total of 122 patients with pulmonary consolidation on chest radiographs underwent color Doppler ultrasonography to evaluate hemodynamic change in regional pulmonary artery in pulmonary consolidation due to various causes. The diseases underlying pulmonary consolidation included 66 simple pneumonia, 37 obstructive pneumonia, 13 tumor consolidation and 6 pulmonary infarctions. Blood flow signals in consolidation were detected by color-flow mapping. The degree of reactive vasoconstriction was evaluated from analysis of the spectral waveform of the blood flow in the segmental pulmonary artery by several vessel resistance-indicating Doppler ultrasound (US) indices, including pulsativity index (PI), resistive index (RI), and acceleration time (AT). The results showed that reactive vasoconstriction was most marked in obstructive pneumonia, followed by simple pneumonia, and least in tumor consolidation (p < 0.001, Kruskal-Wallis test and p < 0.001, Dunn's test for comparison of PI, RI and AT values between different groups of pulmonary consolidation). No flow was detected in pulmonary infarction. We conclude that color Doppler US is a useful tool for evaluating reactive vasoconstriction in pulmonary consolidation. The different degrees of reactive vasoconstriction may be helpful in exploring the possible etiology of pulmonary consolidation.
共有122例胸部X线片显示肺部实变的患者接受了彩色多普勒超声检查,以评估各种原因导致的肺部实变区域肺动脉的血流动力学变化。肺部实变的基础疾病包括66例单纯性肺炎、37例阻塞性肺炎、13例肿瘤性实变和6例肺梗死。通过彩色血流图检测实变区域的血流信号。采用包括搏动指数(PI)、阻力指数(RI)和加速时间(AT)等几种血管阻力指示性多普勒超声(US)指标,通过分析段肺动脉血流频谱波形来评估反应性血管收缩程度。结果显示,反应性血管收缩在阻塞性肺炎中最为明显,其次是单纯性肺炎,在肿瘤性实变中最不明显(p<0.001,Kruskal-Wallis检验;p<0.001,Dunn检验用于比较不同组肺部实变的PI、RI和AT值)。肺梗死区域未检测到血流信号。我们得出结论,彩色多普勒超声是评估肺部实变中反应性血管收缩的有用工具。不同程度的反应性血管收缩可能有助于探究肺部实变的可能病因。