Olcott E W, Jeffrey R B, Jain K A
Department of Radiology, Veterans Affairs Palo Alto Health Care System, Stanford University School of Medicine, CA 94304, USA.
AJR Am J Roentgenol. 1997 Mar;168(3):703-5. doi: 10.2214/ajr.168.3.9057519.
The purposes of this investigation were to compare prospectively the pattern and extent of cystic artery flow revealed by power Doppler sonography and color Doppler sonography in patients with normal gallbladders and to analyze the potential implications of these findings for power Doppler sonography in diagnosing acute cholecystitis.
The cystic arteries of 142 patients (79 women and 63 men) with normal gallbladders were imaged with both power Doppler sonography and color Doppler sonography using 5-MHz transducers and settings optimized to reveal low-volume flow. The presence or absence of cystic artery flow and the anatomic extent of its visualization were recorded for each patient.
Power Doppler sonography revealed flow in 73% of patients with normal gallbladders compared with 53% revealed by color Doppler sonography. Cystic artery flow within the distal fundal quartile was revealed by power Doppler sonography in 20% of patients and flow spanning greater than 50% of the anterior gallbladder wall was revealed by power Doppler sonography in 17% of patients. These findings differed from those of color Doppler sonography at a highly significant level (p < .0001, chi-square test).
Power Doppler sonography is significantly more sensitive than color Doppler sonography for revealing cystic artery flow in patients with normal gallbladders. The flow patterns in patients with normal gallbladders obtained with power Doppler sonography overlap flow patterns previously reported as fairly specific criteria for diagnosing acute cholecystitis using color Doppler sonography, namely, flow within the distal fundal quartile and flow spanning greater than 50% of the anterior gallbladder wall. Accordingly, these color Doppler sonography criteria are not applicable to the diagnosis of acute cholecystitis with power Doppler sonography. Different power Doppler sonography criteria are necessary for the diagnosis of acute cholecystitis.
本研究旨在前瞻性比较正常胆囊患者中，能量多普勒超声和彩色多普勒超声所显示的胆囊动脉血流模式及范围，并分析这些发现对能量多普勒超声诊断急性胆囊炎的潜在意义。
使用5兆赫探头及优化设置以显示低流量血流，对142例正常胆囊患者（79例女性，63例男性）的胆囊动脉进行能量多普勒超声和彩色多普勒超声成像。记录每位患者胆囊动脉血流的有无及其可视化的解剖范围。
能量多普勒超声显示73%的正常胆囊患者有血流，而彩色多普勒超声显示为53%。能量多普勒超声显示20%的患者胆囊底部远端四分位区内有胆囊动脉血流，17%的患者显示血流跨越胆囊前壁超过50%。这些发现与彩色多普勒超声的结果在高度显著水平上存在差异（p <.0001，卡方检验）。
在显示正常胆囊患者的胆囊动脉血流方面，能量多普勒超声比彩色多普勒超声显著更敏感。能量多普勒超声在正常胆囊患者中获得的血流模式与先前报道的使用彩色多普勒超声诊断急性胆囊炎的相当特异的标准，即胆囊底部远端四分位区内的血流和跨越胆囊前壁超过50%的血流相重叠。因此，这些彩色多普勒超声标准不适用于能量多普勒超声诊断急性胆囊炎。诊断急性胆囊炎需要不同的能量多普勒超声标准。
