彩色多普勒超声在原位肝移植术后黄疸鉴别诊断中的价值  

Value of Color Doppler Ultrasonography in the Differential Diagnosis of Postoperative Jaundice after Orthotopic Liver Transplantation

作　　者：周元媛[1] 黄道中[1] 张青萍[1] 陈知水[1] 刘健[1] 王立平[1] 杜敦峰[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《放射学实践》2006年第1期96-98,共3页Radiologic Practice

摘　　要：目的:探讨彩色多普勒超声(CDFI)在原位肝移植术后黄疸鉴别诊断中的应用价值。方法:使用彩色多昔勒超声观察18例原位肝移植术后发生黄疸患者的肝脏动静脉血流变化及胆管、肝实质声像图改变,主要观察指标有最大血流速度、时间平均血流速度(TAV)、阻力指数(RI)及胆管内径,并结合临床资料、肝穿刺活检病理结果和内镜逆行胰胆管造影(ERCP)表现等进行综合分析。结果:18例患者于术后6天-5个月发生黄疸,持续时间为12天-1年。其中13例为胆道并发症,5例为胆总管吻合口狭窄,2例为慢性胆管炎,2例为肝内胆管结石,1例为左肝管胆泥形成并霉菌感染,3 例为肝内胆管轻度扩张,其余5例经肝穿刺活检证实为轻度急性排斥反应4例、临界急性排斥反应1例。结论:彩色多普勒超声成像技术对原位肝移植术后黄疸具有重要的鉴别诊断价值,对临床医生判断病情有重要意义。Objective：To evaluate the value of color doppler ultrasonography in the differential diagnosis of post operative jaundice after orthotopic liver transplantation. Methods：Eighteen jaundice patients after ortbotopic liver transplantation were examined by using color doppler flow imaging to observe hepatic blood flow and the change of hepatic parenchyma and biliary tract by ultrasonography. The measured indexes included the maximum blood flow velocity （Vmax）, time-average blood flow velocity （TAV）, resistance index （RI） and internal dimension of biliary tract. Clinical data, pathology diagnosis of needle biopsy of liver and endoscopic retrograde cholangiopancreatography （ERCP） were compared and analyzed. Results： 13 patients suffered from biliary tract complication,including stricture of anastomose site of common biliary duct in 5 patients （5/18,27.8 % ）, biliary stone in 2 cases （2/18,11% ）, sludge formation in left hepatic duct as well as fungus infection in one patient （1/18,6%）and slightly dilated bile duct in 3 cases （3/18,17%）, the other five patients （27.8%） suffered from mild liver acute rejection diagnosed by needle biopsy of liver. Conclusion：Color doppler ultrasonography is valuable for the differential diagnosis of post-surgery jaundice after orthotopic liver transplantation.

关 键 词：超声检查 多普勒 彩色 肝移植 手术后并发症 

分 类 号：R657.3[医药卫生—外科学]