综合影像方法在肝移植后动脉并发症诊断的应用初探  

Preliminary Study in the Diagnosis of Arterial Complications after Liver Transplantation with Multiple Image Modalities

作　　者：黄勇慧[1] 杨建勇[1] 陈伟[1] 李家平[1] 谢洪波[1] 江利[1] 

机构地区：[1]广州中山医科大学附属第一医院介入放射科,510080

出　　处：《临床放射学杂志》2005年第12期1067-1070,共4页Journal of Clinical Radiology

摘　　要：目的探讨采用超声和CT灌注成像联合诊断肝移植后动脉并发症的应用价值。资料与方法对130例肝移植术后病例先行超声监测,筛选出疑诊肝动脉并发症病例24例,对其中16例行CT灌注成像检查,最后经血管造影和临床追踪确诊或排除疑诊。分别对彩色多普勒检查(CDI)和CT灌注成像(CTP)的特异性和敏感性,以及联合使用多种方法作为系列检查的特异性和敏感性进行计算和比较。结果以单纯CDI的阻力指数(RI)<0.5为指标进行监测,其对肝动脉并发症诊断的敏感性、特异性以及阳性预测值分别为100%、89.83%、50%。如果结合CDI-RI和CTP作为系列检查,其诊断的敏感性、特异性以及阳性预测值分别为100%、99.1%、83.3%。经检验两者在特异性和阳性预测值方面均存在明显差异。结论采用超声和CT灌注成像联合诊断肝移植后动脉并发症将明显提高诊断的特异性和阳性预测值,明显缩短临床观察时间,提高诊断及时性,为肝移植后动脉并发症的及时治疗提供帮助。Objective To evaluate the Value of CDI and CTP in the diagnosis of vascular complications after Liver transplantation. Materials and Methods 130 cases after OLT （orthotopic liver transplantation） were surveiled by CDI （color Doppler ultrasonography image）, and 24 cases were suspected to have arterial complications. Among the suspected cases, 16 were selected to examine by CTP. All diagnoses were identified by clinical evidence and angiography. The sensitivity and specificity of CDI and CTP were calculated and compared. Results The sensitivity, specificity and positive predictive value of the test with the diagnosis criteria as single RI of CDI and combined CDI with perfusion CT, respectively, were as follows： 100% ,89.83 % ,50% （single CDI） and 100% ,99.1% ,83.3% （combined 2 methods）. There was siginificant difference in specificity and positive predictive value combined CDI with perfusion CT. Conclusion High specificity and positive predictive value could be achieved by combining perfusion CT and CDI-RI. We consider that CT and CDI-RI cart surveille arterial complications after OLT, we will diagnose these complications more promptly, and the opportunity of treatment for these complications will not be missed.

关 键 词：肝移植 动脉并发症 超声 CT灌注成像 

分 类 号：R657.3[医药卫生—外科学] R711.6[医药卫生—临床医学]