超声造影评估门静脉高压的可行性研究  

Quantitative evaluation of portal pressure by contrast enhanced uitrasonography

作　　者：曲恩泽[1] 李志艳[2] 刘阳[2] 张明博[1] 张英才[3] 王金锐[1] 

机构地区：[1]北京大学第三医院超声科,北京100191 [2]解放军第三○二医院超声科 [3]中山大学附属第三医院肝移植科

出　　处：《中华超声影像学杂志》2012年第10期859-863,共5页Chinese Journal of Ultrasonography

基　　金：2009年教育部博士点专项基金（20090001110092）

摘　　要：目的探讨超声造影无创评估门静脉压力的可行性。方法对18例拟行脾切除与贲门周围血管离断术的门静脉高压症患者（PHT组）于术前1周内进行肝超声造影，并以20例健康志愿者作为对照组。以肝肾切面为感兴趣区，通过时间强度曲线分别计算门静脉-肝动脉曲线下面积比（Qp／Qa）和门静脉一肝动脉灌注强度比（Ip／Ia）。对PHT患者经由术中门静脉穿刺获取门静脉压力，并进一步分析其与上述参数的关系。结果PHT组与对照组，Qp／Qa分别为2．28±0．66、5．72±3．69，Ip／Ia分别为0．35±0．14、1．97±0．17，差异均有统计学意义。PHT组QP／Qa和Ip／Ia与门静脉压力呈负相关（P〈0．01），其相关系数分别为-0．747和-0．617。两者关系的直线回归方程分别为Y=-83X＋5．013，Y=-15X＋0．837。结论肝超声造影参数Qp／qa和Ip／Ia与门静脉压力有良好的相关性，有望成为临床无刨评估门静脉压力的新方法。Objective To investigate the feasibility of non-invasive quantitative evaluation of portal pressure （Pp） by contrast enhanced ultrasonography （CEUS）. Methods 18 portal hypertension patients （PTH group） were performed with CEUS within one week before splenectomy and pericardial devascularization,and 20 healthy volunteers as controls were recruited in this study （control group）. Hepatic-right kidney sectionwas chosen to calculate the area under curve of portal vein/hepatic artery （Qp/ Qa） and the perfusion intensity of portal vein/hepatic artery （Ip/Ia） through time intensity curves （TIC） of liver parenchyma generated from CEUS images. Pp was measured by intra-operative mesenteric vein catheter,and the correlation betweenPp and Qp/Qa,Ip/Ia were analyzed by Pearson correlation test. Results The levels of Qp/Qa and Ip/Ia in the PTH group were 2, 28 ± 0. 66 and 0. 35 ± 0.14 respectively, which were both significantly declined than that in the controlgroup （5.72 ± 3.69 and 1.97 ± 0. 17）. In the PTH group,the correlation coefficient were -0. 747 and -0. 617, and the linear regression equations were Y = -83 X ± 5. 013 and Y = - 15X ± 0. 837, which indicated that Qp/Qa and Ip/Ia had significant correlation with Pp. Conclusions CEUS parameters,including Qp/Qa and Ip/Ia,are significantly correlated to Pp in portal hypertension patients, which indicate that CEUS could be a new non-invasive clinical method for evaluating Pp.

关 键 词：超声检查 微气泡 高血压 门静脉 

分 类 号：R575.2[医药卫生—消化系统]