心血管腔内烟雾状回声形成与红细胞缗钱叠加的关系

摘要

心血管腔内烟雾状回声是声像图上血流淤滞区内经常出现的一种征象,但其形成机制尚未彻底明了.我们在体外实验研究中发现:红细胞混悬液在声象图上呈现液性暗区,显微镜下见红细胞呈单个离散状态.但如其内加入淋巴细胞分离液,声像图上可立即出现烟雾状回声,镜检时见红细胞互相聚集,呈现缗钱叠加现象.动物实验中发现:生理状态血流速度较快时,声像图上见心血管腔内为液性暗区;显微镜下红细胞呈现单个离散状态.但如血流受阻淤滞,心血管内渐次出现密集的烟雾状回声,镜检时见红细胞也有缗钱叠加现象.缗钱叠加形成时,红细胞聚集,处条索或闭块状态,其形体变大,直径增加,接近或超过超声的波长,故当超声通过时可产生反射.本实验说明:心血管腔内烟雾状回声的出现与红细胞缗钱叠加有密切关系.%Intracardiovascular smoke-like echo always appears in the regions of stasis.Recently,we experimentally found that its appearance closely related to the erythrocytic rouleaux.(1)In vitro study:Erythrocytic suspension was observed by ultrasound and echofree can be seen on its sonogram.Under mi-croscope.the red blood cells presented dispersed phase.If equal amount of lymphocytic separated solution was put in the suspension,smoke-like echo appeared at the original fluid dark area and the red cells pres-ented pattern of rouleaux.(2)Animal experiment:Under physiological condition,velocity of blood flow israpid and echofree can be seen in the cardiovascular cavity.When blood flow velocity becomes slow or stasis,the shear force will reduce and even disappear,SO.red cells aggregated each other with their concave face and formed a rouleaux.As rouleaux structure was formed,its size became larger and it was nearer orlarger than the wavelength of ultrasound.therefre the reflections were produced and smoke-like echoappeared.It might be the mechanism for the formation of intracardiovascular smoke-like echo.