北村 宏, 田中 聡行, 斉藤 拓康, 有賀 浩子, 西牧 敬二, 杉山 敦, 川崎 誠治

Hiroshi KITAMURA, Toshiyuki TANAKA , Hiroyasu SAITOH , Hiroko ARUGA , Keiji NISHIMAKI , Atsushi SUGIYAMA, Seiji KAWASAKI

信州大学第1外科

First Department of Surgery, Shinshu University School of Medicine

キーワード : Color Doppler Energy , Ultrasound, Visceral blood flow

Applications of Color Doppler Energy (CDE), a new color Doppler technique that encodes the power in the Doppler signal in color have been investigated. Here we used this sensitive measure to evaluate blood perfusion in the wall of the alimentary tract intraoperatively, to help ensure successful anastomosis and to detect ischemia of the bowel. An ultrasound system (Acuson, Model 128) was used with a modification in the method of Doppler data processing, useing the method of Rubin. Anastomoses of the stomach and the small and large intestines were evaluated in terms of sufficiency of blood supply for successful anastomosis. CDE was used in abdominal surgery on an aortic aneurysm to aid in the decision of whether or not the inferior mesenteric artery should be reconstructed to prevent colonic ischemia. CDE clearly demonstrated blood flow in the submucosal layer of the wall of the small intestine, stomach, and colon under normal conditions. A patent collateral pathway was indicated when the blood supply of the wall of the colon was not altered significantly by clamping the inferior mesenteric artery. CDE may prove to be the simplest and most reliable modality for evaluating intestinal blood flow when confirmation of sufficient blood supply is necessary during surgical intervention.