Jeffrey R B, Nino-Murcia M, Ralls P W, Jain K A, Davidson H C
Department of Radiology, Stanford University Medical Center, CA 94305, USA.
J Ultrasound Med. 1995 Jan;14(1):33-6. doi: 10.7863/jum.1995.14.1.33.
Color Doppler sonography was used to evaluate the length and distribution of the cystic artery in the gallbladder wall in 115 normal adults and in 54 patients with surgically proved cholecystitis. All patients were scanned with a 5 MHz curved array transducer optimized for low volume color sensitivity. A specific attempt was made to visualize the cystic artery throughout its course. Spectral Doppler waveforms were obtained to document arterial flow. The length of the cystic artery visualized was analyzed as a quartile percentage length of the anterior gallbladder wall. The distribution of the cystic artery flow also was analyzed in specific quartiles. Of 54 patients with acute cholecystitis, 26% had cystic artery length greater than half of the anterior gallbladder wall, compared with 2% of 115 normal controls (P < 0.001); 19% of patients with cholecystitis had flow in the distal (fundal) quartile, compared to 0% of normal controls (P < 0.0001). Although the presence or absence of flow in the gallbladder is not a reliable finding to establish the diagnosis of acute cholecystitis, length of cystic artery visualized is a potentially useful criterion to suggest the diagnosis of acute cholecystitis, especially in cases in which flow in the distal fundal quartile of the gallbladder. The usefulness of color Doppler sonography in acute cholecystitis is limited owing to the fact that it is insensitive, and many patients with cholecystitis have no detectable flow or have normal flow patterns.
采用彩色多普勒超声检查评估115例正常成年人及54例经手术证实为胆囊炎患者胆囊壁内胆囊动脉的长度及分布情况。所有患者均使用经优化以提高低容量血流敏感性的5MHz凸阵探头进行扫描。特别尝试全程观察胆囊动脉。获取频谱多普勒波形以记录动脉血流情况。将观察到的胆囊动脉长度分析为胆囊前壁长度的四分位数百分比。还对胆囊动脉血流在特定四分位数中的分布情况进行了分析。在54例急性胆囊炎患者中，26%的患者胆囊动脉长度大于胆囊前壁的一半，而115例正常对照者中这一比例为2%（P<0.001）；19%的胆囊炎患者胆囊动脉血流位于远端（底部）四分位数区域，而正常对照者中这一比例为0%（P<0.0001）。尽管胆囊内有无血流并非诊断急性胆囊炎的可靠依据，但观察到的胆囊动脉长度是提示急性胆囊炎诊断的一个潜在有用标准，尤其是在胆囊远端底部四分位数区域有血流的情况下。彩色多普勒超声在急性胆囊炎诊断中的作用有限，因为其敏感性较低，而且许多胆囊炎患者检测不到血流或血流模式正常。
