Murphy T P, Cronan J J
Department of Diagnostic Imaging, Rhode Island Hospital, Providence.
Crit Care Clin. 1994 Apr;10(2):341-63.
Ultrasonography plays an increasingly important role in the evaluation of the vascular system. It is especially useful for the intensive care patient because of its ability to be performed at the patient's bedside, as well as the relatively high frequency of vascular complications in the ICU. Ultrasonography is the method of choice for evaluation of deep vein thromboembolic disease of the lower extremity in all patients, demonstrating excellent sensitivity and specificity for this condition. It also should be the initial method of evaluating upper extremity deep vein thrombosis. It may be limited in this assessment, however, because it does not reliably demonstrate the central subclavian and innominate veins, and therefore may be inadequate for evaluation of malfunctioning central venous catheters. Ultrasonography can reliably identify the presence of abdominal aortic aneurysms, although computed tomography is better able to demonstrate location and extent of these lesions. Finally, ultrasonography can be used to diagnose complications of arterial catheterization and, in selected patients, may direct compression of pseudoaneurysms, resulting in thrombosis and thereby averting surgical repair.
超声检查在血管系统评估中发挥着越来越重要的作用。由于其能够在患者床边进行，以及重症监护病房（ICU）中血管并发症的发生率相对较高，所以它对重症监护患者尤为有用。超声检查是评估所有患者下肢深静脉血栓栓塞性疾病的首选方法，对这种疾病具有出色的敏感性和特异性。它也应该是评估上肢深静脉血栓形成的初始方法。然而，它在这种评估中可能存在局限性，因为它不能可靠地显示锁骨下静脉和无名静脉，因此可能不足以评估中心静脉导管功能异常。超声检查能够可靠地识别腹主动脉瘤的存在，尽管计算机断层扫描更能显示这些病变的位置和范围。最后，超声检查可用于诊断动脉插管的并发症，在特定患者中，还可指导对假性动脉瘤进行压迫，导致血栓形成，从而避免手术修复。
