超声检测肝门部胆管在鉴别肝移植术后胆道狭窄类型中的价值  

Identification of different types of biliary strictures after orthotopic liver transplantation by hilar bile duct using ultrasonography

作　　者：曾婕[1] 任杰[1] 郑荣琴[1] 廖梅[1] 毛永江[1] 吕艳[1] 

机构地区：[1]中山大学附属第三医院超声科中山大学超声诊断与介入超声研究所,广州510630

出　　处：《中华超声影像学杂志》2012年第5期394-396,共3页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金资助项目（30901465）

摘　　要：目的探讨超声检测肝门部胆管在鉴别肝移植术后胆道狭窄类型中的价值。方法回顾分析胆道狭窄患者超声检查肝门部胆管声像图，对肝门部胆管有无扩张、管腔是否显示清晰、管壁有无增厚、管壁回声4项指标进行评价。结果62例非吻合口狭窄和30例吻合口狭窄患者肝门部胆管有无扩张、管腔是否显示清晰、管壁有无增厚比较差异有统计学意义（均P〈0．001）。以肝门部胆管无扩张、管腔显示不清、管壁增厚为诊断胆道狭窄中非吻合口类型的指标，以肝门部胆管管腔显示不清的诊断性能为最高，其敏感性、特异性及准确性分别为93．7％、86．7％和92．3％。结论肝门部胆管的观察对鉴别肝移植术后两种胆道狭窄类型具有重要价值，以管腔是否显示清晰能较好区分二者。Objective To explore the feasibility of hilar bile duct using ultrasonography （US） in identification of different types of biliary strictures after orthotopie liver transplantation. Methods The US images of hilar bile duct of 62 patients with non-anastomotic biliary stricture （NAS） and 30 patients with anastomotic biliary stricture （AS） were reviewed. Four US feathers including the presence of hilar biliary dilatation,the display of hilar biliary lumen, the thickening of bile duct wall and the echo of bile duct wall were assessed. Results The presence of hilar biliary dilatation, the display of hilar biliary lumen, the thickening of bile duct wall showed a significant difference between NAS and AS groups （ P d0.001）. The feature with the greatest performance in the diagnosis of NAS was unclear displayed hilar biliary lumen. The sensitivity, specificity and accuracy were 93.7~, 86.7~ and 92.3%, respectively. Conclusions The observation of hilar bile duct has great vaule in identification of different types of biliary strictures after orthotopic liver transplantation. The display of hilar biliary lumen is more likely to differentiate between NAS and AS.

关 键 词：超声检查 肝移植 胆道疾病 

分 类 号：R657.3[医药卫生—外科学]