超声造影与流速剖面技术评价肝硬化程度的临床意义  

Clinical value of contrast-enhanced ultrasonography and color Doppler velocity profile in assessment of liver cirrhosis degree

作　　者：王晓艳[1] 林礼务[1] 薛恩生[1] 何以敉[1] 高上达[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,福州350001

出　　处：《中华超声影像学杂志》2006年第11期809-812,共4页Chinese Journal of Ultrasonography

基　　金：福建省科委研究基金资助(2000Z138)

摘　　要：目的应用超声造影观察门脉右支开始显影时间以及彩色多普勒流速剖面技术检测门脉右支流速和血流量,以探讨其评价肝硬化程度的临床价值。方法23例乙型病毒性肝炎后肝硬化患者,分为肝硬化代偿组(11例)和肝硬化失代偿组(12例)。非肝硬化患者24例作为对照组。观察门脉右支开始显影时间,并检测门脉右支流速和血流量,分别比较各参数之间差异并进行相关性分析。结果肝硬化组门脉右支开始显影时间较非肝硬化对照组明显延长(P<0.01),平均流速、最高流速以及血流量较对照组明显降低(P<0.01)。肝硬化失代偿组门脉右支开始显影时间较肝硬化代偿组明显延长(P<0.05),平均流速、最高流速以及血流量较肝硬化代偿组明显降低(均P<0.01)。肝硬化患者门脉右支开始显影时间与门脉右支平均流速、最高流速以及血流量之间均存在明显负相关(P<0.05)。结论随着肝硬化程度的加重,门脉右支开始显影时间逐渐延长,流速和血流量逐渐下降,两者之间呈明显负相关性,能较好地反映肝硬化代偿期和失代偿期门脉血流动力学变化情况,对于评价肝硬化程度具有较高的临床价值。Objective To probe the clinical value in the assessment of liver cirrhosis degree by arrival time of right portal vein with contrast-enhanced uhrasonography and velocity and flow volume with color Doppler velocity profile（CDVP）. Methods Twenty-three patients with posthepatitic cirrhosis grouped into compensatory liver cirrhosis（11 cases） and decompensatory liver cirrhosis（12 cases） were enrolled in this study, and 24 patients with non cirrhosis liver disease consisted of the control group. All cirrhosis cases were pathologically proved after percutaneous biopsy. SonoVue was injected to detected the arrival time of right portal vein. The velocity and flow volume of right portal vein were measured. The difference of every parameter were compared to analyze the relativity. Results The arrival time of right portal vein was much longer in liver cirrhosis group than in non-cirrhosis group [（25.70 ± 1.61 ） s vs （21.38 ± 0.59） s respectively, P 〈0.01]. The mean velocity, maximal velocity and flow volume were much lower in liver cirrhosis group than in non-cirrhosis group E（10.80± 0.87） cm/s vs （14.80 ± 0.63）cm/s, （14.18 ± 1.04） cm/s vs （17.70 ± 0.72）cm/s and （366.87 ± 23.87） ml/min vs （499.83 ± 12.94） ml/min, respectively, P 〈 0.01]. With the development of liver cirrhosis, the arrival time of right portal vein became even longer （P （0.05）, and the velocity and flow volume became even lower （P 〈 0.01）. There was negative correlation between arrival time and mean velocity, maximal velocity and flow volume of right portal vein in liver cirrhosis group （r = -0.547, P （0.01; r = -0.508, P 〈0.05; r =-0.471, P 〈0.05, respectively）. Conclusions With the development of liver cirrhosis, the arrival time of right portal vein prolongs gradually, the velocity and flow volume of right portal vein decreases remarkedly, and there is negative correlation between the results of two methods.

关 键 词：超声检查 造影剂 肝硬化 门静脉 血液动力学现象 

分 类 号：R575.2[医药卫生—消化系统] R445.1[医药卫生—内科学]