Sigel B, Coelho J C, Flanigan D P, Schuler J J, Machi J, Beitler J C
Ann Surg. 1982 Oct;196(4):473-80. doi: 10.1097/00000658-198210000-00011.
Real-time high resolution ultrasound imaging was employed during reconstructive vascular operation in 165 patients. The purpose of this diagnostic procedure was to detect unrecognized strictures, thrombi, and intimal flaps in order to permit their surgical correction at the primary operation. Defects were discovered in 48 patients (29%). In 34 patients (21%), because of size and location, defects were not considered sufficiently significant to warrant re-exploration. In 14 patients (8%), ultrasound revealed defects that prompted immediate re-exploration. Patients with ultrasound defects considered to be insignificant did as well as patients with no demonstrable defects. In the 14 patients who were re-explored, 12 had major defects that were corrected. These 12 patients also did well after operation. In two of the 14 patients, defects could not be found at re-exploration. Both these patients experienced early thrombosis of bypass grafts. In 56 patients, ultrasound was compared with arteriography at the same operation. The accuracy of operative ultrasound and operative arteriography was 96% and 85%, respectively. Operative ultrasound is more accurate, simpler and safer than arteriography and may be the preferred method for detection of vascular defects at reconstructive surgery.
对165例患者在血管重建手术中采用实时高分辨率超声成像。该诊断程序的目的是检测未被识别的狭窄、血栓和内膜瓣，以便在初次手术时对其进行手术矫正。48例患者（29%）发现有缺陷。34例患者（21%）因缺陷的大小和位置，被认为严重程度不足以进行再次探查。14例患者（8%）超声显示有缺陷，促使立即进行再次探查。被认为无意义的超声缺陷患者与无明显缺陷的患者情况相同。在接受再次探查的14例患者中，12例有需要矫正的重大缺陷。这12例患者术后情况也良好。在14例患者中的2例，再次探查时未发现缺陷。这2例患者均出现了旁路移植物早期血栓形成。在56例患者中，在同一手术中对超声与动脉造影进行了比较。术中超声和术中动脉造影的准确率分别为96%和85%。术中超声比动脉造影更准确、更简单、更安全，可能是重建手术中检测血管缺陷的首选方法。
