Dab tsi yog thawj yam uas tib neeg feem ntau xav txog niaj hnub no? Lawv xav tias dab tsi yog qhov tseem ceeb tshaj plaws hauv lub neej? Tau kawg, kev noj qab haus huv. Nyob rau hauv lub xyoo pua 21st, cov kab mob plawv feem ntau tshwm sim, rau lawv cov kev kho mob tag nrho nws yog ib qho tsim nyog yuav tsum tau ua qhov kev kuaj mob, suav nrog kev kuaj xyuas cov hlab ntsha thiab cov leeg.
Cov kab lus piav qhia yuav ua li cas ultrasound ntawm cov hlab ntsha ua tiav, qhov txheej txheem no qhia tau li cas, cov hlab ntsha twg tau kuaj xyuas siv ultrasound.
Definition
Vascular ultrasound yog kev kawm txog cov hlab ntsha thiab cov leeg ntawm lub cev siv txoj kev ultrasound. Qhov kev ntsuam xyuas thib ob hauv qhov zaus ntawm kev teem sijhawm tom qab echocardiography.
Kev kuaj mob ntawm cov kab mob vascular tau nce siab heev tom qab kev qhia txog cov tshuab ultrasound rau hauv tsev kho mob. Nws tuaj yeem kuaj xyuas cov hlab ntsha los ntawm sab hauv, tsis ua txhaum kev ncaj ncees. Nrog rau kev txhim kho ntawm txoj kev tshawb fawb tshiab (ib-dimensional, ob-dimensional, Doppler), qhov zoo ntawm kev pom thiab kev kuaj pom tseeb tau nce siab dua.
Lawv ua li cas?
Cov txheej txheem yuav tshwm sim hauv qhov tsaus ntujnyob rau hauv tsev, tus neeg yuav tsum nyob rau hauv ib qho yooj yim txoj hauj lwm. Ultrasound ntawm cov hlab ntsha ntawm qis extremities yog ua thaum tus neeg mob pw ntawm nws lub plab. Hauv lwm qhov xwm txheej, koj yuav tsum tau pw ntawm koj nraub qaum.
txhawm rau txhim kho daim tawv nqaij sib cuag, lub transducer yog lubricated nrog gel uas ua ultrasound. Yog tsis muaj nws, huab cua nyob nruab nrab ntawm daim tawv nqaij thiab cov transducer ua rau txo qhov pom ntawm cov qauv.
Kev xeem yeej ib txwm ua ntawm ob sab - sab laug thiab sab xis. Nyob rau hauv no txoj kev, lub degree thiab symmetry ntawm qhov txhab raug soj ntsuam.
Rendering issues
Thaum tus kws kho mob tso lub sensor rau ntawm daim tawv nqaij, nws pib nrhiav cov hlab ntsha uas tsim nyog rau kev kuaj xyuas. Tus kws kho mob pom lawv cov txheej txheem txheej txheem, ntsuas qhov loj me, cov ntshav khiav nrawm, saib xyuas qhov muaj cov kab mob pathological: atherosclerotic plaques, ntshav txhaws, sib cais ntawm txheej sab hauv ntawm phab ntsa vascular.
Nws tuaj yeem xav txog tag nrho cov saum toj no tsuas yog pom pom tau zoo. Tab sis muaj cov xwm txheej thaum muaj teeb meem rau kev pom thaum lub sij hawm ultrasound ntawm cov hlab ntsha:
- Thick txheej ntawm subcutaneous rog. Hauv qhov no, ultrasound tsuas tuaj yeem ncav cuag qhov tob uas lub nkoj dag.
- Lub caj dab luv ua rau muaj kev nyuaj hauv kev kawm. Hauv qhov no, cov hlab ntsha tsis ncaj. Lawv nyob hauv cov dav hlau sib txawv. Rau kev kuaj mob zoo, tus kws kho mob yuav xav tau sijhawm ntxiv me ntsis.
- Kev mob hnyav ntawm ob txhais ceg kuj txo qhov muaj peev xwm pom cov hlab ntsha, zoo li thawj kis.
- Qhov muaj qhov txhab qhib ntawm qhov taw qhia qhov project yuam tus kws kho mob mus nrhiav lwm qhov chaw raunrhiav pom cov hlab ntsha lossis cov hlab ntsha hauv cheeb tsam no.
Txhua tus neeg yog tus kheej, thiab txhua tus yuav tsum hloov kho kom ua tiav qhov kev xeem uas tau teb cov lus nug ntawm tus kws kho mob zoo tshaj plaws.
Type of exams
Muaj ntau cov hlab ntsha hauv tib neeg lub cev: cov hlab ntsha thiab cov hlab ntsha ntawm ntau txoj kab uas hla, hlab ntsha, venules, capillaries. Lawv nkag mus rau txhua lub cev, cov qauv, xa cov khoom muaj txiaj ntsig nrog cov ntshav thiab noj cov khoom pov tseg ntawm cov hlwb.
Hmoov tsis zoo, tsis yog txhua tus tuaj yeem pom ntawm ultrasound. Tsuas yog cov hlab ntsha loj thiab nruab nrab txoj kab uas hla yuav raug rau qhov kev ntsuam xyuas no. Capillaries thiab venules thiab arterioles ua ntej lawv tsis tuaj yeem pom los ntawm lub cuab yeej.
Feem ntau, cov kws kho mob tau sau ntawv mus kuaj:
- Neck.
- Nyob.
- Ntxhais ceg tawv.
- Heart (ntau yam tsawg).
Ultrasound ntawm caj dab hlab ntsha
Tus neeg mob tau hais kom pw ntawm nws nraub qaum thiab tsa nws lub puab tsaig me ntsis, qee zaum tig nws lub taub hau mus rau sab. Tus kws kho mob tshuaj xyuas raws li kev txiav txim:
- Common carotid hlab ntsha (CCA).
- Nws bifurcation (qhov chaw ntawm kev faib mus rau hauv thiab sab nraud carotid hlab ntsha). Nws yog nyob rau hauv qhov chaw no uas muaj cov atherosclerotic plaque feem ntau pom.
- External carotid artery.
- Internal carotid artery mus rau qhov chaw nkag rau hauv pob txha taub hau.
- Cov hlab ntsha vertebral (VA) hauv thawj ob ntu - ua ntej nws nkag mus rau hauv tus txha nraub qaum thiab hauv cov txheej txheem ntawm cov pob txha.
- Subclavian hlab ntsha.
- Qhov chaw ntawm cov kab mob carotid thiab vertebral hlab ntsha ntawm sab laug.
- Lub cev brachycephalic ntawm sab xis thiab nwsbifurcation rau hauv OCA thiab PA.
- Jugular veins.
Tau kawg, yog tias kuaj pom pathology thaum lub sijhawm ultrasound ntawm cov hlab ntsha ntawm lub caj dab hauv nws qhov qis, qhov kev ntsuam xyuas tuaj yeem txuas mus rau sab sauv qaum.
kuaj ultrasound ntawm cerebral hlab ntsha
Nws ib txwm ua ua ke nrog rau yav dhau los. Nws tso cai rau koj los soj ntsuam cov ntshav khiav hauv lub hlwb, cov qauv ntawm lub voj voog ntawm Willis - cov hlab ntsha uas ua rau cov ntshav ntws mus rau lub hlwb. Txawm hais tias ib qho hlab ntsha tsis ua haujlwm, tsis muaj dab tsi yuav tshwm sim rau lub hlwb, vim tias lwm tus them nyiaj tag nrho. Nws yog cov hlab ntsha no uas cov kws tshaj lij tab tom sim pom.
Rau ultrasound ntawm cov hlab ntsha ntawm lub paj hlwb, ib qho chaw nkag nrog cov pob txha nyias nyias yog siv - lub tuam tsev, thiab qhov ntsuas qhov me tshaj plaws yog ib feem. Thaum kawm, tus kws kho mob qhia tag nrho lub voj voog ntawm Willis lossis cov hlab ntsha loj hauv lem, yog tias lawv tsis nyob hauv tib lub dav hlau.
Yeej, cov kws kho mob tshwj xeeb tshuaj xyuas cov hlab ntsha hauv nruab nrab, nruab nrab thiab tom qab lub paj hlwb thiab cov hlab ntsha sab hauv, tom qab sib txuas lus. Hauv txhua qhov, cov ntshav khiav nrawm hauv txhua ntu thiab qhov ntsuas ntawm qhov tsis kam rau cov ntshav ntws tau raug ntsuas. Tus kws kho mob kuj kos xim rau qhov sib luag ntawm qhov ntsuas ntawm ob sab.
Qee zaum tus kws tshaj lij tsis tuaj yeem tshem tawm ib leeg hlab ntsha. Qhov no tsis yog vim nws cov professionalism tsawg. Qhov no tshwm sim vim muaj cov khoom tshwj xeeb ntawm cov pob txha. Nyob rau hauv rooj plaub no, nws sim ua kom pom lawv los ntawm sab nraud, tab sis qhov no tsis yog ib txwm ua tau vim qhov tob tob.tshwm sim ntawm nkoj.
Nyob hauv lub hlwb, nws tseem ceeb heev kom taug qab cov hlab ntsha vertebral, uas sib koom ua ke rau hauv cov hlab ntsha loj. Lub suboccipital fossa yog siv los ua "qhov rais". Ultrasound ntawm cov hlab ntsha ntawm lub hlwb yog nqa tawm ua ntej pw, tom qab ntawd sawv. Tib qhov ntsuas tau raug soj ntsuam raws li hauv txoj kev tshawb fawb los ntawm kev nkag mus rau lub cev thiab kev hloov pauv hauv cov ntshav ntws thaum lub sij hawm verticalization ntawm tus neeg mob.
Kev qhia
Vim tias ob txoj hauv kev tau piav qhia saum toj no ib txwm ua ua khub, cov lus qhia rau lawv siv yog tib yam:
- mob taub hau;
- kiv taub hau;
- tinnitus;
- migraine;
- ntshav siab;
- stroke;
- kev hloov pauv ischemic nres;
- convulsions (xav tias muaj mob vwm);
- vestibular mob;
- cerebral ischemia;
- vertebrosobasilar insufficiency;
- mob plawv ischemic;
- atherosclerosis ntawm txhua qhov chaw;
- nqaij mos raug mob ntawm caj dab;
- sudden blindness.
Kev kuaj cov hlab ntsha ntawm qis qis
Kab mob ntawm cov hlab ntsha thiab cov hlab ntsha sib nrug me ntsis, tab sis muaj qhov tshwm sim loj heev hauv cov pej xeem. Yog vim li cas rau qhov no yog qhov tsis muaj los yog tsis txaus ntawm kev tiv thaiv ntawm no pathology. Ultrasound ntawm cov hlab ntsha ntawm qis qis tso cai rau koj los txiav txim qhov ua rau cov tsos mob cuam tshuam nrog kev taug kev.
Tam sim ntawd ua ntej kev kawm, txawm tias nws yog cov hlab ntsha lossis cov hlab ntsha, koj yuav tsum tshem tawm tag nrho cov khaub ncaws hauv qab lub duav, suav nrog cov thom khwm, tshwj tsis yog cov ris tsho hauv qab. Tom ntej no, tus neeg mob pw ntawm nws nraub qaum thiab ua raws li tag nrho cov lus qhia.tus kws kho mob.
Thaum kawm, tus kws kho mob tshwj xeeb tshuaj xyuas cov hlab ntsha thiab cov hlab ntsha. Cov hlab ntsha raug kuaj rau atherosclerosis, thrombosis. Thaum lub nkoj raug thaiv nyob rau hauv cheeb tsam ntawm lub inguinal quav, mus nrhiav rau sab sauv ciam teb ntawm qhov txhab, txoj kev kawm txav mus rau hauv lub plab mog, yog li lub aorta los yog inferior vena cava tej zaum yuav cuam tshuam.
Cov ntshav ntws tau kuaj tsis tau poob. Yog tias xav tias atherosclerosis ntawm cov hlab ntsha, tus kws kho mob yuav tsum ntsuas lub siab ntawm ob txhais ceg kom txiav txim siab qhov ntsuas ntawm pob taws-brachial (ABI). Ib lub cuff yog muab tso rau ntawm qhov qis ntawm tus ncej puab lossis sab sauv ntawm ceg, uas yog nqus tau pa. Lub sijhawm no, tus kws kho mob saib xyuas cov ntshav ntws nrog lub sensor. Thaum lub pulsation nres, nws nco ntsoov tus lej sib raug ntawm lub tonometer thiab pib ntsuas ntawm cov hlab ntsha tom ntej. Yog li tus kws kho mob yuav tsum xam qhov ABI tsawg kawg yog 4 zaug ntawm ob txhais ceg - raws li cov hlab ntsha hauv cov ceg qis.
Yog xav tias muaj kab mob vein thrombosis, ultrasound ua tau zoo heev. Nyob rau hauv lawv lub cev ib txwm, nws yog ib qhov tsim nyog yuav tau compress cov hlab ntsha nrog ib tug sensor thiab ua ib qho kev sim nrog tuav lub pa thiab straining tom ntej. Qhov no xyuas qhov ua haujlwm ntawm cov hlab ntsha li qub. Yog hais tias muaj cov tsos mob ntawm thrombosis nrog ib tug cais apex nyob rau hauv lub lumen, xws li ib tug kev kuaj mob yuav tsis muaj peev xwm ua tau, vim hais tias muaj peev xwm ntawm detachment ntawm ib feem ntawm lub thrombus nrog rau pulmonary embolism tom ntej.
Qhia rau ultrasound ntawm cov hlab ntsha ntawm sab qis:
- txias qis qis;
- paj ntawm daim tawv nqaij ntawm ob txhais ceg;
- tsis muaj cov hlab ntsha tawg ntawmko taw;
- mob pob txha thaum taug kev;
- qaug zog hauv ob txhais ceg;
- mob ntshav qab zib mellitus;
- ntev qhov txhab tsis kho, ceg rwj;
- dub ntawm daim tawv nqaij ntawm ko taw;
- keeb kwm haus luam yeeb ntev;
- ntshav siab cholesterol.
Kev ntsuas rau kev kuaj ntshav:
- o loj heev ntawm ob txhais ceg, feem ntau asymmetric;
- lub zos reddening ntawm daim tawv nqaij ntawm ob txhais ceg;
- muaj xim av pigmentation thiab coarsening ntawm daim tawv nqaij nyob rau hauv lub shins;
- suppuration ntawm ceg;
- ceg mob thaum so;
- xav kom puv ceg;
- dilated saphenous leeg.
Vajtswv lub siab
Rau kev ua haujlwm ib txwm muaj, lub plawv xav tau cov ntshav tsis cuam tshuam, uas cov hlab ntsha lossis cov hlab ntsha coronary yog lub luag haujlwm.
Tsis tas li ntawd, cov hlab ntsha loj tawm ntawm lub plawv: lub ntsws pulmonary, aorta, inferior thiab superior vena cava, pulmonary veins. Muaj 2 txoj hauv kev los ua ultrasound ntawm cov hlab ntsha ntawm lub plawv:
Transthoracic - dhau lub hauv siab. Ua ke nrog ultrasound ntawm lub plawv. Thaum lub sij hawm tus txheej txheem, tus kws tshwj xeeb tshuaj xyuas lub ntsiab trunks extending ntawm nws thiab nqa ntshav rau nws. Cov no yog aorta, pulmonary trunk, vena cava thiab pulmonary veins
Intravascular ultrasound tso cai rau koj los tshuaj xyuas sab hauv ntawm cov hlab ntsha coronary uas pub lub plawv cov leeg. Kev kuaj mob yog nqa tawm ua ke nrog coronary angiography. Ib qho me me ultrasonic sensor yog ntxig raws tus neeg xyuas pib thiab nce mus rau lub coronaries nyob rau hauv kev tswj ntawm lub tshuab X-ray. Daim ntawv ntsuam xyuas pub rau hauv qhov tsawg tshaj plawskawm cov phab ntsa ntawm cov hlab ntsha hauv kev nthuav dav, txiav txim siab cov duab ntawm cov quav hniav, nws muaj pes tsawg leeg. Tsis tas li ntawd, qhov no yog txoj hauv kev zoo tshaj plaws ntawm kev pom thiab kev tswj xyuas thaum stenting lossis balloon dilatation (txoj hauv kev nthuav dav lumen ntawm cov hlab ntsha cuam tshuam los ntawm cov txheej txheem pathological). Txoj kev no tau siv thoob plaws ntiaj teb los ntawm cov kws phais plawv, roentgen angiosurgeons. Tsis tshua muaj tshwm sim hauv peb lub tebchaws
Cov lus qhia rau ultrasound ntawm cov hlab ntsha ntawm lub plawv (kev kuaj mob intravascular):
- kev ntsuas ntawm arterial stenosis;
- kev ntsuas kev ua haujlwm shunt;
- tswj kev ua haujlwm endovascular.
Results
Tom qab ultrasound ntawm cov hlab ntsha, tus kws tshaj lij sau cov txheej txheem kuaj. Yuav tsum muaj qhov ntau thiab tsawg, nrawm, ntsuas. Kev kuaj pom pathology tau piav qhia ntau npaum li qhov ua tau los txiav txim siab qhov muaj zog tom qab kho. Vascular ultrasound qhia dab tsi thiab cov lus xaus tuaj yeem pom hauv cov txheej txheem?
Nyob rau hauv cov hlab ntsha ntawm txhua txoj kab uas hla, atherosclerotic hloov pauv ntawm ntau qib tau kuaj pom. Nws tuaj yeem tsuas yog thickening ntawm IMT (nruab nrab thiab sab hauv phab ntsa) lossis cov quav hniav. Nyob rau hauv lub xub ntiag ntawm lub tom kawg, lub degree ntawm stenosis yuav tsum ntsuas raws li ib feem pua thiab cov kev hloov nyob rau hauv cov ntshav khiav yog qhia ua ntej thiab tom qab nqaim ntawm lub lumen.
Thaum kuaj pom cov hlab ntsha thrombosis, qhov txwv sab saud tau txiav txim siab, qhov kev txav mus los ntawm sab saum toj ntawm cov hlab ntsha yog ntsuas. Kev saib xyuas tshwj xeeb yog them rau cov qauv ntawm thrombus, homogeneous lossis tsis, txawm tias muaj cov tsos mob ntawm cov ntshav ntws hauv cov hlab ntsha. Yog li, nrog qee qhov kev tshwm sim, nws muaj peev xwm txiav txim siab cov tshuajtxheej txheem thiab kev kho mob prognosis.
kuaj mob qhov twg?
Ultrasound yog ib txoj hauv kev zoo heev los kuaj xyuas ntau yam kab mob, suav nrog cov hlab ntsha. Ultrasound tuaj yeem ua tau raws li tus kws kho mob tuaj koom dawb ntawm txhua lub tsev kho mob. Tab sis feem ntau koj yuav tau tos koj lub sijhawm ob peb hnub lossis ob peb asthiv.
Yog xav tias muaj tus kab mob venous thrombosis, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob sai sai, lawv yuav ua txhua yam kev kuaj mob tsim nyog.
Tab sis qhov twg yuav ua ultrasound ntawm cov hlab ntsha tsis nkim sij hawm thiab qab haus huv? Hauv ib lub chaw kho mob ntiag tug muaj lub sijhawm los kuaj xyuas tib hnub. Koj tsis tas yuav thov kev xa mus los ntawm koj tus kws kho mob rau qhov no. Lawm, tus txheej txheem yuav raug them.
Tom qab kawm, tus kws tshaj lij yuav qhia rau koj tias yuav tiv tauj leej twg yog tias koj muaj kab mob, yuav xav li cas. Hauv qhov tshwj xeeb, tus kws kho mob hu lub tsheb thauj neeg mob xa tus neeg mob mus rau tsev kho mob kho.
