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CT顯示腘動脈粥樣硬化閉塞

CT顯示腘動脈粥樣硬化閉塞

動脈粥樣硬化可能涉及外周動脈,特別是腿部,從髂動脈開始并延伸至股動脈,腘動脈和小腿動脈。圖示CT血管造影,右側腘動脈閉塞,可見有血流進入側支動脈分支。并發癥包括運動耐量降低、疼痛和缺血性改變,最終導致壞疽。

踝肱指數(ABI)可檢測外周血管疾病,可用袖帶和多普勒超聲測量。首先在手臂中部的肱動脈水平測量收縮壓,然后在踝的水平測量收縮壓。 ABI是踝部收縮壓與肱動脈收縮壓的比值。 ABI通常應為1.0。低于0.85可診斷為外周血管疾病。

另一種測量是動脈血液流入腿部時發生的體積變化的容量記錄(PVR)。通過沿著大腿、小腿、腳踝和大腳趾放置多個壓力袖帶來執行PVR。袖帶充氣至40-60mmHg。腿中的體積變化與通過換能器記錄的袖帶中的壓力隨時間的變化相關。

Atherosclerosis may involve peripheral arteries, particularly the leg, starting from the iliac arteries and extending to femoral, popliteal, and lower leg arteries. Shown here with CT angiography is an occlusion of the right popliteal artery. There is runoff into a collateral arterial branch. Complications include reduced exercise tolerance, pain, and ischemic changes that can culminate in gangrenous necrosis.

The ankle-branchial index (ABI) can document peripheral vascular disease and is measured with a manual blood pressure (BP) cuff and a Doppler ultrasound device. With DU the systolic arterial occlusion pressure is measured, first at the level of the brachial artery in the arm, then at the level of the ankle. ABI is the ratio of ankle occlusion pressure to brachial artery occlusion pressure. The ABI should normally be 1.0. An ABI below 0.85 is consistent with PAD.

Another measure of peripheral vascular disease that performed along with ABI is pulse-volume recording (PVR) of volume changes that occur with arterial blood flow into the leg. PVR is performed by placing multiple pressure cuffs along the thigh, calf, ankle, and great toes. The cuffs are inflated to 40-60 mm Hg. Changes in the volume in the leg correlate with changes in pressure in the cuff that are recorded via a transducer over time.



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