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目的探讨囊状动脉瘤模型的声像图和血流动力学特征以及超声对其血管内栓塞效果的评价。方法利用用显微外科技术于犬颈总动脉制成三种类似于人类的囊状动脉瘤模型其中侧壁型,12例、分叉型4例、末端型6例。术后7～14d彩超观察瘤腔载瘤动脉及瘤体内血流动力学改变栓塞后再行彩超检查观察其疗效并与、。,MRA、DSA及病理检查结果对比。结果三种类型动脉瘤均有相似的血流模式瘤腔内血流分为三个血流区,:1)沿远侧瘤壁进入的流入区;2)沿近侧瘤壁出去的流出区和3)中心缓慢涡流区。流入区峰速高于流出区。②侧壁型动脉瘤内血流速较慢,易形成部分性血栓而分叉型和末端型动脉瘤内血流,速高。③血管内治疗后血流显示,19例动脉瘤腔闭塞,2例瘤颈部有残腔,1例弹簧圈略脱出瘤颈导致载瘤动脉狭窄。④超声结果与MRA、DSA及病理结果完全一致。结论①各型动脉瘤模型有相似的血流模式。②侧壁型动脉瘤顶部易形成部分血栓。③双功超声能观察载瘤动脉及瘤体内血流动力学改变,可作为动脉瘤及栓塞治疗效果无创评价的方法之一。
Objective To investigate the sonographic and hemodynamic characteristics of the cystic aneurysm model and evaluate the effect of intravascular embolization by ultrasound. Methods Three types of cystic aneurysms similar to human were made by microsurgical technique in the canine carotid artery. Among them, 12 were lateral wall type, 4 were forked type and 6 were terminal type. 7 ~ 14d after operation observed tumor cavity tumor-bearing artery and tumor hemodynamics change after embolization and then color Doppler ultrasound examination and observe its efficacy and. , MRA, DSA and pathological examination results contrast. Results All three types of aneurysms had similar blood flow patterns. The intraluminal blood flow was divided into three regions of blood flow: 1) the inflow area along the distal tumor wall; 2) the outflow area along the proximal tumor wall And 3) center slow swirl zone. Inflow into the zone peak velocity higher than the outflow zone. ② sidewall aneurysm blood flow slower, easy to form a partial thrombosis and end-type aneurysm bifurcation flow, high speed. ③ blood flow after endovascular treatment showed that 19 cases of aneurysm cavity occlusion, 2 cases of tumor neck residual cavity, a case of coil slightly out of the neck leading to tumor-bearing artery stenosis. ④ ultrasound results and MRA, DSA and pathology results are exactly the same. Conclusions ①All aneurysm models have similar blood flow patterns. ② the formation of the top of the sidewall-type aneurysm is easy to form part of the thrombus. ③ Biphasic ultrasound can observe the changes of hemodynamics in the parent artery and tumor, which can be used as one of the non-invasive evaluation methods for aneurysms and embolization.