目的 观察症状性和无症状性颈内动脉狭窄患者支架置入术(CAS)前后颈内动脉狭窄侧与健侧收缩期峰值流速比值(rPSV)、阻力指数比值(rRI)变化,并探讨其临床意义.方法 选择行CAS治疗的颈内动脉狭窄患者43例,有明显缺血性卒中、短暂性脑缺血发作等症状者26例(有症状组),无明显症状者17例(无症状组).所有患者CAS治疗前后分别测量患侧与健侧收缩期峰值流速(PSV)、阻力指数(RI),计算rPSV、rRI.结果 有症状组CAS治疗前rPSV高于CAS治疗后,rRI低于CAS治疗后(P均<0.05).无症状组CAS治疗前rPSV高于CAS治疗后(P<0.05),但CAS治疗前后rRI比较P>0.05.结论 症状性颈内动脉狭窄患者接受CAS治疗后rPSV明显降低、rRI明显升高,无症状性颈内动脉狭窄患者接受CAS治疗后rPSV明显降低,而rRI变化不明显.因此,CAS更适合治疗症状性颈内动脉狭窄.

报告一例经超声诊断的腹壁子宫内膜异位症患者。该患者有剖宫产手术史；手术切口瘢痕处结节，质硬，边界欠清，有触痛；有与月经相关的周期性切口瘢痕处疼痛等临床表现；超声表现：肿块位于腹壁切口处皮下软组织内，呈中低回声结节，边界欠清，形态欠规则，且彩色多普勒血流显像显示肿块内部及边缘可见血流信号，脉冲多普勒显示血流信号为低速高阻的动脉频谱。考虑符合腹壁子宫内膜异位症的诊断。术后病理诊断为子宫内膜异位症伴炎症反应。超声检查具有简便、快捷、经济、无痛苦、可重复性强等优点，并能动态观察病情变化，是诊断子宫内膜异位症的首选方法。 A patient with abdominal wall endometriosis diagnosed by ultrasonography was reported. The patient had a history of cesarean section. A hard and tender nodule with unclear border was found at the scar of surgical incision. There was periodic scar pain related with menstruation. Ultraso-nography showed the nodule located in the subcutaneous soft tissue of the surgical incision, with low echoes, unclear border and irregular shape. Color Doppler showed blood flow signals around and inside the mass, which were demonstrated as “low speed and high resistance” by Pulse Doppler. The data above supported the diagnosis of endometriosis. The pathologic diagnosis after surgery was endometriosis accompanied with inflammatory reaction. Ultrasonography had many advantages such as convenient, fast, inexpensive, painless, and repeatable. In addition, it could monitor the changes of diseases. Ultrasonography was the preferred method for diagnosis of endometriosis.