儿科肝移植术前的血管影像学检查  

Preoperative vascular imaging in pediatric liver transplantation

作　　者：Ravindra K.V. Guthrie J.A. Woodley H. M.D. Stringer 贺莉 

机构地区：[1]Children' s Liver and GI Unit, St. James' s University Hospital, Beckett St, Leeds LS9 7TF, United Kingdom

出　　处：《世界核心医学期刊文摘（儿科学分册）》2006年第2期32-33,共2页

摘　　要：Background/Purpose: There is a considerable variation in the use of vascular imaging techniques in the preoperative assessment of children scheduled for liver transplantation. Duplex Doppler ultrasound scan (US), magnetic resonance angiography (MRA), and conventional angiography are used to varying extents. The authors compared the results of preoperative vascular imaging studies with operative findings to determine their accuracy and usefulness. Methods: Results of preoperative vascular imaging in 37 consecutive children undergoing cadaveric liver transplantation were compared with operative findings. Those undergoing relatively elective transplantations were investigated by US and MRA (group 1), whereas those requiring urgent transplants were assessed only by US (group 2). Results: The median age of the cohort (15 boys; 22 girls) was 4 years (19 days to 16 years) and the median weight was 17 kg (2.9 to 82 kg). In group 1 (n = 26), 20 children had a normalcaliber, patent portal vein at transplant and 6 had a narrow but patent portal vein requiring venous reconstruction in 4. The sensitivity and specificity of MRA in the detection of an abnormally narrow portal vein were 100% (6/6) and 95% (19/20), respectively. If reversed or absent flow in the portal vein on US was taken as an indication of a potentially abnormal vein, the sensitivity and specificity of Doppler US were 83% (5/6) and 95% (19/20), respectively. Magnetic resonance angiography revealed arterial anomalies in 4 children but failed to detect small accessory hepatic arteries in 5. The single patient with an aberrant vena cava was identified by MRA. In group 2 (n = 11), venous findings at operation and on US were concordant in 10 (91% ) cases; one infant with reversed flow in the portal vein on US had a thrombosed vein at surgery. Magnetic resonance angiography was useful in 2 patient groups: those with reversed flow on Doppler US or suspected portal vein thrombosis in whom an abnormal portal vein was present in 86% (6/7) and infants with the biliary atBackground/Purpose： There is a considerable variation in the use of vascular imaging techniques in the preoperative assessment of children scheduled for liver transplantation. Duplex Doppler ultrasound scan （US）, magnetic resonance angiography （MRA）, and conventional angiography are used to varying extents. The authors compared the results of preoperative vascular imaging studies with operative findings to determine their accuracy and usefulness. Methods： Results of preoperative vascular imaging in 37 consecutive children undergoing cadaveric liver transplantation were compared with operative findings. Those undergoing relatively elective transplantations were investigated by US and MRA （group 1 ）, whereas those requiring urgent transplants were assessed only by US （group 2）. Results： The median age of the cohort （ 15 boys; 22 girls） was 4 years （19 days to 16 years） and the median weight was 17kg （2. 9 to 82 kg） . In group 1 （n = 26）, 20 children had a normalcaliber, plant and 6 had a narrow but patent portal vein at transpatent portal vein requiring venous reconstruction in 4. The sensitivity and specificity of MRA in the detection of an were 100% （6/6） and 95% （19/20）, respectively. If reversed or absent flow in the portal vein on US was taken as an indication of a potentially abnormal vein, the sensitivity and specificity of Doppler US were 83% （5/6） and 95% （19/20）, respectively.

关 键 词：肝移植术 影像学检查 血管影像学 术前 磁共振血管造影术 MRA检查 US检查 二维多普勒 门静脉异常 儿科 

分 类 号：R657.3[医药卫生—外科学] R739.41[医药卫生—临床医学]