彩色多普勒血流显像检测移植肝血流参数变化对于评估移植肝及对并发症早期诊断的价值  

Hemodynamic Changes on Color Doppler Flow Imaging for Assessing Liver Transplantation and Early Complication Diagnosis

作　　者：黄道中[1] 张青萍[1] 陈云超[1] 周元媛[1] 朱蔚[1] 张超[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,武汉市430030

出　　处：《中国超声医学杂志》2006年第11期852-854,共3页Chinese Journal of Ultrasound in Medicine

基　　金：湖北省科技攻关课题资助项目(No.2005AA301C31)

摘　　要：目的利用彩色多普勒血流显像(CDFI)检测移植肝血流动力学参数变化,评估移植肝状况及对其并发症早期诊断的价值。方法利用CDFI检测75例原位肝移植者不同时期肝动、静脉及门静脉峰值血流速度(PS)、时间平均血流速度(TAV)、阻力指数(RI)、肝动脉血流灌注指数(DPI),并与30例正常人进行对照;利用静脉超声造影检测7例肝移植者造影声像图。结果(1)移植术后23例无明显并发症者血流动力学基本变化是15d内门静脉TAV明显高于正常对照组(P<0.05);术后肝动脉PS、DPI7d之内显著低于7d之后(P<0.05),RI在7d之内显著高于7d之后(P<0.05);(2)肝动脉血栓形成时,肝动脉PS明显降低直至消失,门静脉TAV明显增高呈锯齿波,DPI明显降低;(3)排异反应时,门静脉TAV降低、肝动脉PS降低、RI增高、肝静脉三相波消失呈锯齿波或类门静脉平稳波等;(4)移植肝DPI降低时,移植肝胆道并发症容易发生;(5)超声造影显示7例肝移植术后5例肝癌复发者显示动脉期快速增强,门脉期及实质相呈相对低回声。结论CDFI检测移植肝脏门静脉、肝动脉及肝静脉血流动力学参数变化可以用来评估正常及有并发症的移植肝脏。Objective To discuss the value of color Doppler flow imaging （CDFI） for assessing liver transplantation and early diagnosis of complication by examining hemodynamic changes. Methods Seventy-five cases with orthotopic liver transplantation （OLT） underwent CDFI. Following results were obtained including peak systolic velocity （PS）, resistance index （RI） and Doppler perfusion index （DPI） of the hepatic artery （HA）, time average velocity （TAV） of portal vein （PV） as well as velocity of hepatic vein （HV） in four different stages after operation and 30 healthy subjects enrolled as the control group. Results （1）In the patients without obvious complication,TAV of PV was increased 15 days after operation （P〈0.05）, and PS of HA decreased but RI risen compared with those in the control group （P〈0.05） 7 days after operation. （2） When the hepatic artery thrombosis （HAT） occurred, PS of HA and DPI was obviously decreased, but TAV of PV significantly increased like a high sawtooth wave. （3） while the livers of transplantation were rejected, TAV of PV and PS of HA were decreased, RI increased, and the triphasic wave of HV disappeared. （4） Biliary complication of liver transplantation was increased when DPI was decreased. （5） five cases with hepatic carcinoma demonstrated hyperechoic in the arterial phase and hypoechoic in the portal and later phases on ultrasonography. Conclusions The hemodynamic changes of PV, HA and HV in liver transplantatiopn are valuable for assessing the liver transplantation and early diagnosing the complications on CDFI.

关 键 词：彩色多普勒超声检查 肝移植 血流动力学 术后并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学]