彩色多普勒超声对门静脉瘤栓的血流动力学研究及其诊断价值  

Diagnosis value of color Doppler in analysing hemodynamics of portal vein tumor thrombosis

作　　者：林礼务[1] 林学英[1] 何以敉[1] 高上达[1] 薛恩生[1] 俞丽云[1] 

机构地区：[1]福建医科大学附属协和医院超声科福建省超声医学研究所,福州350001

出　　处：《中华超声影像学杂志》2004年第11期821-824,共4页Chinese Journal of Ultrasonography

基　　金：福建省科委研究基金项目(2000Z138)

摘　　要：目的　探讨彩色多普勒超声对门静脉癌栓(PVTT)的诊断价值以及PVTT的血流动力学特 点。方法　病理或(和)临床确诊的原发性肝细胞癌伴PVTT患者38例,肝硬化门静脉血栓患者16例。 对癌栓与血栓进行二维超声定位,并对其周边与内部进行彩色血流检测,观察其动脉与门静脉血流的显示 率以及相关血流动力学参数。结果　癌栓组的周边与内部均以动脉血流为主,其显示率分别为81.6% (31/38)与86.8%(33/38),均明显高于血栓组的动脉血流显示率[31.6%(5/16)与6.3%(1/16),均P< 0.01];而血栓周边仍以显示门静脉血流为主,达68.8%(11/16),高于癌栓组(P<0.01)。同时,癌栓组周 边动脉血流的最高流速与阻力指数分别为(141.45±58.36)cm/s与0.69±0.04,明显高于血栓组 [(102.32±18.21)cm/s与0.59±0.05,均P<0.05]。结论　应用彩色多普勒显示门静脉癌栓内部的动 脉血流对PVTT诊断具有较高的敏感性和特异性。Objective To probe the diagnostic value of color Doppler flow imaging(CDFI) in analysing hemodynamics of portal vein tumor thrombosis(PVTT). Methods Thirty-eight patients had hepatocellular carcinoma with PVTT and 16 patients had cirrhosis with portal vein blood thrombosis diagnosed pathologically and (or) clinically. Color Doppler ultrasonography was adopted to detect tumor thrombosis(TT) and blood thrombosis(BT) as well as their periphery and inner blood flow. The detected rates of pulsatile and continuous flow as well as related hemodynamic parameters were also observed. Results The periphery and interior of TT group were mainly pulsatile flow, and their detected rates were 81.6%(31/38) and 86.8% (33/38) respectively, markedly higher than those of BT group as 31.6%(5/16) and 6.3%(1/16) respectively(P< 0.01). The detected rate of continuous flow in the periphery of BT group was up to 68.8%(11/16), apparently higher than that of TT group(P< 0.01). The peak velocity and resistive index of pulsatile flow in the periphery of TT group were ( 141.45± 58.36)cm/s and 0.69± 0.04 respectively, markedly higher than those of BT group as ( 102.32± 18.21)cm/s and 0.59± 0.05 respectively(P< 0.05). Conclusions The detection of pulsatile flow in PVTT by CDFI is a sensitive and specific method to diagnose of PVTT.

关 键 词：彩色多普勒超声 门静脉瘤栓 血流动力学 超声检查 肿瘤循环细胞 

分 类 号：R735.7[医药卫生—肿瘤]