Ohno Yasuharu, Fujimoto Tamotsu, Shibata Yukari
Department of Surgery, Oita Children's Hospital, Oita City, Oita, Japan.
Department of Pediatrics, Oita Children's Hospital, Oita City, Oita, Japan.
Eur J Pediatr Surg. 2017 Feb;27(1):20-25. doi: 10.1055/s-0036-1593381. Epub 2016 Oct 3.
Superb microvascular imaging is a new ultrasound image processing technique that uses advanced clutter suppression to extract flow signals from vessels and which helps us visualize very small vascular structures that were not previously visible without the use of a contrast agent. We herein analyzed the usefulness of superb microvascular imaging in the diagnosis of hepato-gastrointestinal disorders in pediatric patients. Fifty-six pediatric patients who underwent a total of 81 superb microvascular imaging examinations with an Aplio 300 ultrasound system (Toshiba Medical Systems, Tokyo, Japan) were enrolled in this study. The subjects underwent conventional ultrasound examinations, including Doppler imaging followed by superb microvascular imaging. The superb microvascular imaging findings and standard imaging were compared. All of the examinations were performed without sedation. The average age of the patients (male, = 38; female, = 18) was 4 years. The clinical diagnoses included hepatobiliary disorders ( = 29), acute appendicitis ( = 10), and other intestinal disorders ( = 17). The target organs for superb microvascular imaging were the liver, appendix, rectum, intestine, gallbladder, and lymph node. In most of the patients, superb microvascular imaging achieved the excellent visualization of microvascular structures, revealing abnormal vasculature in 21 out of 46 (45.7%) examinations of the liver, 9/9 (100%) examinations of the appendix, 0/11 (0%) examinations of the rectum, 9/11 (81.8%) examinations of the intestine, 0/1 (0%) examinations of the gallbladder, and 3/3 (100%) examinations of the lymph nodes. Superb microvascular imaging was superior to Doppler imaging for depicting the microvascular structures. Superb microvascular imaging is especially useful for depicting the microvascular flow and can aid in the diagnosis and treatment planning for pediatric patients with hepato-gastrointestinal disorders.
超微血管成像技术是一种新的超声图像处理技术，它利用先进的杂波抑制技术从血管中提取血流信号，有助于我们可视化以前不使用造影剂就无法看到的非常小的血管结构。我们在此分析了超微血管成像技术在小儿肝胃肠疾病诊断中的应用价值。本研究纳入了56例小儿患者，他们使用Aplio 300超声系统（日本东京东芝医疗系统公司）共接受了81次超微血管成像检查。这些受试者先接受常规超声检查，包括多普勒成像，然后进行超微血管成像。比较了超微血管成像的结果和标准成像。所有检查均未使用镇静剂。患者的平均年龄为4岁（男性38例，女性18例）。临床诊断包括肝胆疾病（29例）、急性阑尾炎（10例）和其他肠道疾病（17例）。超微血管成像的目标器官为肝脏、阑尾、直肠、肠道、胆囊和淋巴结。在大多数患者中，超微血管成像实现了微血管结构的良好可视化，在46次肝脏检查中有21次（45.7%）显示血管异常，9次阑尾检查中有9次（100%）显示异常，11次直肠检查中有0次（0%）显示异常，11次肠道检查中有9次（81.8%）显示异常，1次胆囊检查中有0次（0%）显示异常，3次淋巴结检查中有3次（100%）显示异常。在描绘微血管结构方面，超微血管成像优于多普勒成像。超微血管成像对于描绘微血管血流特别有用，有助于小儿肝胃肠疾病患者的诊断和治疗规划。
