不同探头在穿刺中的特点

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                    <p style="line-height: 2em;">(1) 线阵探头：此型探头一般频率高，可动态聚焦，分辨力高，图像清晰，视野开阔，图像</p><p style="line-height: 2em;">呈长方形，探头较其他类型大，接触面较宽，稳定性好，穿刺时便于把持。缺点是探头底面较宽，灵活性差，穿透力低，所以一般多用于浅表部位的引导穿刺。如图14为Ultrasonix L14‐5开发的线阵探头穿刺架。</p><p style="line-height: 21.3333px;"><br  /></p><p style="line-height: 2em;"><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0c9P220mCCrK546IKWIoyrbia2wxsCu6XthJIu0dmwvCEX48RuN2vun6w/0?wx_fmt=png" data-ratio="0.854389721627409" data-w="467"  /><br  /></p><p style="line-height: 2em;">(2) 凸阵探头：显像方式类似扇形图形，探头接触面介于线阵和相控阵探头之间。凸阵扫査</p><p style="line-height: 2em;">图像结合了线性扫査的近场大和扇形扫査远场大的优点，适合于腹部脏器、浅表与深部的超声引导穿刺。缺点是探头较大，凸面稳定性差，引导进针时死角较大，皮肤进针点距离目标较远。有的凸阵扫描探头，探头接触面较宽，扫描盲区极小，安装穿刺架后，亦能获得类似扇形探头的穿刺效果。随着超声引导下介入应用的增多，很多超声厂家都开发了小凸腹部探头专门用于介入操作，这种探头体积小、频率相对比较高、盲区小，在安装上穿刺架后，适合在人体的各个部位进行穿刺操作，如下图15‐ 17，是小凸探头穿刺架。</p><p style="line-height: 21.3333px;"><br  /></p><p style="line-height: 2em;"><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0c0YC8CsNRgL9elXc4qnKAf4KxDMOUCk1c0WrRdzzChnta9QmedL6Iug/0?wx_fmt=png" data-ratio="0.7485795454545454" data-w="704"  /><br  /></p><p style="line-height: 2em;">(3) 相控阵探头：体积较小，比线阵扫描探头在技术上更精密复杂，可以作扇形扫描或聚焦</p><p style="line-height: 2em;">声束扫描，图像质量更高。图像呈扇形，图像两侧质量稍差，且稳定性不如线阵探头。此型探头有如下优点：探头接触面小，可用于经肋间等窄小部位穿刺；应用范围广；便于加压，以缩短体表至穿刺目标的距离，提高穿刺准确性；穿刺针接近探头中心位置，穿刺时不易偏离扫描平面，穿刺针与扇形扫描声束所形成的角度大，反射信号强，显示清晰，穿透力高，是用于腹部穿刺较理想的探头。如图18、19为GE S1‐5相控阵探头和Philips S4‐1相控阵探头开发的穿刺架。</p><p style="line-height: 21.3333px;"><br  /></p><p style="line-height: 2em;"><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0czDmsicAJ8Gax0D3b4y2nich62TjL54BTuOsZCKto29af0YFyUeUhTHnA/0?wx_fmt=png" data-ratio="0.5168350168350169" data-w="594"  /><br  /></p><p style="line-height: 2em;">(4) 经直肠、经阴道探头：扫描夹角可达240度，适用于经直肠、经阴道、经会阴穿刺，</p><p style="line-height: 2em;">如图20‐22分别为：经阴道穿刺架、经直肠穿刺架、经直肠探头及经会阴穿刺架。</p><p style="line-height: 21.3333px;"><br  /></p><p style="line-height: 2em;"><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0cA6viadBuACzvicBf3kC1tLQaUN3GpnlI3JnUXb1rIm7ZyPUZLtFmMDiaA/0?wx_fmt=png" data-ratio="0.8067700987306065" data-w="709"  /><br  /></p><p style="line-height: 2em;">(5) 容积探头（包括机械4D探头和矩阵容积探头）：该类型的探头，一般体积比较大，重</p><p style="line-height: 2em;">量比较重，因此用该型探头做穿刺的医院相对比较少。但随着临床方面对穿刺方面的研究深入，不断有医生进行三维穿刺的研究，由于能够在实时的情况下看到穿刺针在三个视觉面上的路径或位置，相对于二维穿刺理论上会安全很多，如图23‐25，分别GE RAB6‐D机械容积探头穿刺架、Philips X6‐1矩阵容积探头穿刺架、Philips 3D9‐3V腔内容积探头穿刺架。</p><p style="line-height: 21.3333px;"><br  /></p><p style="line-height: 2em;"><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0cEHZwGEAVcdJXfdV56xibbVWvicKuVicp1RLicubswHchItKuianmdR8QKlQ/0?wx_fmt=png" data-ratio="0.4698085419734904" data-w="679"  /><br  /><img data-s="300,640" data-type="png" src="http://mmbiz.qpic.cn/mmbiz_png/dx3KibwtDhvcE2dNZZsDGo0jwFuF60w0cHPV1THx3r0Mufszv24u5cc3w2zJAuP9PAfgV2d97rzwJMJzxhRucnA/0?wx_fmt=png" data-ratio="0.625560538116592" data-w="446"  /></p><p style="line-height: 21.3333px;"><br  /></p><p style="max-width: 100%; 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