Objective To explore the effect of endovascular treatment guided by ultrasonography combined with portosystemic shunts on the patients with Budd-Chiari Syndrome （BCS）.Methods The clinical data of 136 patients with BCS treated by balloon angioplasty and stent implantation guided by Doppler ultrasonography in our hospital from January 1995 to January 2011 were retrospectively analyzed.After balloon angioplasty,53 patients were treated by inferior vena cava （IVC） stent implantation and 31 patients with hepatic venous occlusion underwent portosystemic shunts （PSSs） at one week after endovascular treatment.The long-and short-term effects after treatment were studied.Results After endovascular procedures,the IVC pressure of patients significantly decreased （P＜0.01）,while IVC diameter, flow velocity in the lesion,and right atrial pressure of patients showed significant increase（P＜0.01）.Slight heart dysfunction appeared in 13 cases of patients.After shunting,acute pancreatitis occurred in 3 cases, and 1 patient died of upper gastrointestinal hemorrhage on the 10 d after PSSs.Doppler ultrasonography for IVC and shunt vessels showed：the swollen liver and spleen lessened on 3d after endovascular procedures.The swollen liver lessened 2-7cm （mean 5.5cm）,swollen spleen lessened 3-8cm （mean 5.8cm）, and the time of ascites disappearance was 3-60d （mean 14d）.All the patients were followed up for 1 month to 15 years with an average of 3 years.Restenosis of the distal part of stent was found in 1 patient in 2 years after operation, hepatic vein occlusion occurred in 1 case in 1 year after treatment,hepatocellular carcinoma occurred in 1 patient in 3 years after stent implantation,and 1 patient died of C type hepatitis after 1 year,and 5 out of 6 cases of patients with infertility had babies after 1 year.All patients had no stent migration or occlusion of shunts and the symptoms of portal hypertension were obviously relieved.Conclusions Endovascular treatment guided by Doppler ultrasonography is a convenient,safe,and effective method for BCS.Portosystemic shunts are commended to patients with hepatic venous occlusions.The above mentioned methods provide a feasible and effective means for IVC stenosis and short segment occlusion with hepatic vein occlusion of BCS.
ObjectiveTo evaluate the ultrasonic pre locating internal jugular venous cannulation in infants, comparison with the external landmark technique.MethodsSixty two infants scheduled for cardiac surgery were randomized prospectively into two groups. In the anatomic landmarks group( n =30), the patient’s internal jugular vein(IJV) were cannulated by using the traditional method of palpation of carotid pulsation and identification of other anatomic landmarks. In the ultrasonic pre locating group ( n =32), an two dimensional ultrasound scanner image made for locating the puncture site of vessels was used with an operative probe of HP SONOS 4500 system. The number of attempts, success rate, and incidence of complications were compared for two groups.ResultsThe success rate was 100% vs 80% in the ultrasonic pre locating group vs anatomic landmarks group, with a 3.1% vs 26 7% incidence of carotid artery punctures and the number of attempts 1.57±1.04 vs 2.55±1.76. All differences were statistically significant ( P lt;0.05,0.05,0.01). Conclusion Ultrasonographic pre-localization of the IJV is superior to the anatomic landmarks technique in terms of overall success , and decreases incidence of carotid artery puncture.
OBJECTIVE: To discuss clinical application of the color Doppler ultrasonography in diagnosis and treatment of cavernous hemangioma in deep subcutaneous tissue. METHODS: From 1996, 15 cases of cavernous hemangioma were diagnosed and located with color Doppler ultrasonography and were embolized under monitoring of the ultrasonography or resected by operation before re-examination of the hemangioma via the color Doppler ultrasonography after the intervention. RESULTS: Direct embolization was achieved in 10 cases after pinpoint location of the hemangioma by the ultrasonography, and guided embolization was performed successfully in 2 cases via the monitoring of ultrasonography, and operation had to be adopted to remove the focus. No reoccurrence of the hemangioma was observed in all the cases. CONCLUSION: Cavernous hemangioma in deep subcutaneous tissue could be easily diagnosed and located with color Doppler ultrasonography, and could be removed by embolization under monitoring of the ultrasonography successfully.
Objective To compare the axial length (AL) measured with IOLMaster and contact A-Scan in eyes with macular edema (ME) and to investigate the correlation between measurement difference and foveal thickness.Methods Sixty-seven ME eyes of 42 patients (ME group) and 40 healthy eyes of 30 participants (control group) were enrolled in this study. Foveal thickness was measured with 3D optical coherence topography (OCT)-1000. The AL was prospectively measured by IOLMaster and contact A-scan.The correlation between measurement difference and foveal thickness was analyzed by Pearson correlation analysis.Results Mean foveal thickness of ME eyes was (377.85plusmn;119.84) mu;m. Mean AL by IOLMaster and contact A-scan were (22.95plusmn;0.97) mm and (22.82plusmn;1.04) mm in ME group, and (23.21plusmn;1.08) mm and (23.17plusmn;1.15) mm in the control group respectively. The difference between two groups was statistically significant (t=-3.102,P=0.003). There was no correlation between measurement difference and foveal thickness in ME group (r=-0.097;P=0.447). Conclusions There is a difference of AL measurements using contact A-scan and IOLMaster in ME eyes. However, there was no correlation between measurement difference and the foveal thickness.
Objective To explore the characteristics and diagnostic values of ultrasound examination of retinoblastoma (RB).Methods The ultrasound and CT features of 210 eyes (162 patients) with pathologically confirmed RB were analyzed retrospectively. Results The ultrasonography image of those RB eyes were all characterized by substantial masses in the posterior segment of the eyeball, shown as spherical, hemispherical and irregular in shape, and even filled the entire eyeball. Calcification within the mass was observed in 197 eyes of 149 patients (92.0%), but not observed in 13 eyes of 13 patients (8.0%).Colorful blood flow signals extended from the central retinal vessels could be seen inside the masses of all patients. Ultrasound diagnosis was consistent with the pathological diagnosis in 92.0% RB cases. CT examination revealed calcified speckles or plaques in 167 eyes from 145 patients (89.5%), consistent with the pathological diagnosis of RB.Conclusions Ultrasonography can show the tumorprime;s shape, size, internal features and the range of orbital involvement. It is a valuable clinical tool in the diagnosis of RB.
Objective To observe the effect of laser-Doppler retinal blood flowmeter in diabetic retinopathy. Methods The blood flow volume (VOL), the blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of peri-papillary retina were measured with the non-invasive Heidelberg Retinal Flowmeter (HRF) in 108 patients (216 eyes) with diabetes and 32 patients (64 eyes) in normal control group. The patients with diabetes were divided into non-diabetic retinopathy (NDR) group (27 patients, 54 eyes) and non-proliferative diabetic retinopathy (NPDR) group (81 patients, 162 eyes). NPDR group were subdivided into 3 groups: 26 patients (52 eyes) in mild group, 24 patients (48 eyes) in moderate group, and 31 patients (62 eyes) in severe group. The foveal avascular zone area (FAZ) was measured by fundus flourescein angiography (FFA) in patients with diabetes and some in the control group. The data in each group were statistically analyzed. Results The parameter of retinal blood flow of temporal and nasal peri-papillary retina in NDR and NPDR group was significantly lower than that in the control group (Plt;0.05). With the degree of retinopathy becoming more severe, the FLW and VEL of temporal and nasal peri-papillary retina in NDR and mild NPDR group presented ascending tendency, reached the peak in moderate NPDR group, and then decreased. The change tendency of the FLW was more obviously. The VOL of temporal and nasal peri-papillary retina in moderate NPDR group was obviously higher than that in the other groups (Plt;0.01).The FLW and the VEL of temporal and nasal peri-papillary retina in moderate NPDR group were significantly higher than that in mild NPDR and NDR group (Plt;0.01). The FLW and the VEL of temporal peri-papillary retina in severe NPDR group were obviously higher than that in NDR group (Plt;0.01). Blood sugar value positively correlated with degree of diabetic retinopathy (r=0.172，P=0.046). The FLW and the VEL of temporal peri-papillary retina positively correlated with FAZ area in patients with diabetes (r=0.268, P=0.000；r=0.275, P=0.000). The FAZ area positively correlated with the degree of macular degeneration in patients with diabetes (r=0.559, P=0.000). Conclusion As a non-invasive method for measurement of retinal blood flow, HRF has important value in revealing the mechanism and degree of pathological changes and choice of treatment for diabetic retinopathy. (Chin J Ocul Fundus Dis,2007,23:256-259)
ObjectiveTo observe the morphologic characteristics of color Doppler flow imaging (CDFI) and blood stream in patients with retinopathy of prematurity, and provide the new clinical diagnostic gist.MethodsCDFI was performed on 78 patients (156 eyes) with ROP at Ⅳ and Ⅴ stage, who had the diseases history such as prematurity and low birthweight which had been diagnosed by indirect ophthalmoscope, underwent the examination of CDFI. Morphologic characteristics of the results of CDFI and features of blood flow of the pathological changes were observed. ResultsIn the patients with ROP at the Ⅳ stage, a weak zonal echo originated from one side of peripheral wall of eye ball in the vitreous body, and extended to the echo of post pole and wall of eye ball and joined the echo of optic disc. In the patients with ROP at the V stage, lumplike echo connected closely with echo of lens and the circumambience was surrounded; the focus looked like lotus when combined with retinal detachment: the swelled “corona” wrapped and tightly connected with the lens, and the thin “caulis” showed weak zonal echo which attached to the optic disc. The features of blood flow showed the signal of blood stream connected with central retinal artery at the “caulis”, which was analyzed by Doppler spectrum as the bloodflow spectrum of artery and vein in the same direction which was the same as the central retinal artery and vein.ConclusionsIn patients with ROP at the IV and V stage, the results of CDFI mainly shows zonal or lumplike echo, in which the bloodflow signal extended with central retinal artery could be seen. The morphological changes of CDFI and the features of blood flow are useful in diagnosis of ROP. (Chin J Ocul Fundus Dis, 2005,21:282-284)
Objective To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors. Methods UBM (Mode 840, Humphrey, 50 MHz 5 mm×5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B-scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation. Results Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations. Conclusion UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body. (Chin J Ocul Fundus Dis, 2002, 18: 128-130)
Objective To present stereoscopic image of rhegmatogenous retinal detachment with three-dimentional reconstruction of sonography． Methods Ultrasound data were collected by Hpsonos 1500 and 7.0MHz transducter with the motor controlled by computer．Three-dimentional image were reconstructed with Tomtec echoscan． Results Three-dimentional image were successfully reconstructed in 14 eyes of 13 cases of retinal detachment include 3 eyes of 3 cases with opaque refractive medium showing stereosopic image of retina and some retinal tears． Conclusion Static three-dimentional reconstruction of sonography might enhance the ability to visulize spatial anatomic structure of retina and offer a new method to find retinal tears in patients with opague refractive medium． (Chin J Ocul Fundus Dis,1998,14:24-25)