比较超声造影与超声多普勒在门静脉高压诊断中的价值  

Comparison of the Value of Contrast-enhanced Ultrasonography and Ultrasonic Doppler in the Diagnosis of Portal Hypertension

作　　者：陈敏[1] 聂影 刘青[3] 郭晓东[1] 

机构地区：[1]解放军第302医院,北京100039 [2]解放军323医院超声科,陕西西安710038 [3]空军临潼航空医学鉴定训练中心,陕西临潼760002

出　　处：《现代生物医学进展》2012年第32期6282-6284,6302,共4页Progress in Modern Biomedicine

摘　　要：目的:比较超声造影参数与多普勒参数评估门静脉高压(PHT)的准确性,旨在探讨超声造影用于PHT诊断的可行性。方法:选择我院收治的肝硬化合并PHT患者50例,定义为PHT组,所有患者均自愿接受FPP的测定。另选择未合并PHT的乙肝患者50例,定义为对照组。所有患者测量门静脉内径(PVD),门静脉流速(PVV),肝动脉阻力指数(HARI)和脉搏指数(HAPI)。再计算出肝动脉到门静脉的渡越时间(PV-HA)和肝动脉到肝静脉的渡越时间(HV-HA)。结果:PHT组的PVD、HARI和HAPI均显著大于对照组,差异存在统计学意义(PVD:t=3.421,P=0.002;HARI:t=3.223,P=0.001;HAPI:t=3.108,P=0.000)。另外,PHT组的HV-HA显著小于对照组,差异有统计学意义(t=4.868,P=0.000)。而PHT组的PV-HA则显著大于对照组,差异有统计学意义(t=3.969,P=0.000)。HV-HA与FPP呈负相关(r=-0.878,P=0.000),PV-HA与FPP呈正相关(r=0.829,P=0.000),HARI和HAPI虽然同样与FPP呈正相关,但相关性较造影参数低(HARI:r=0.658,P=0.000;HAPI:r=0.742,P=0.000)。结论:多普勒参数与FPP的相关性较低。超声造影参数HV-HA和PV-HA能够敏感提示门静脉高压并且与FPP的相关性更高,所以能更准确、可靠地评估门静脉压力。Objective： To compare the accuracy of the PHT assessment by contrast-enhanced ultrasonography and ultrasonic Doppler in order to investigate the feasibility of portal hypertension （PHT） diagnosis by contrast-enhanced ultrasonography. Methods： Fifty patients with cirrhosis combined with PHT in our hospital were involved and defined as the PHT group. All patients in the PHT group were voluntarily accepted to the determination of FPP. Meanwhile, Fifty patients with hepatitis without PHT were involved and defined as the control group. The portal vein diameter （PVD）, portal vein velocity （PVV）, hepatic artery resistance index （HARI） and pulse index （HAPI）, transit time of portal vein-Hepatic artery （PV-HA） and the transit time of hepatic vein-Hepatic artery （HV-HA） of all patients were measured. Results： The PVD, HARI and HAPI in the PHT group were significantly greater than those in the control group. The differences were statistically significant （PVD： t = 3.421, P = 0.002; HARI： t = 3.223, P = 0.001; HAPI： t = 3.108, P = 0.000）. In addition, the HV-HA in the PHT group was significantly lower than that in the control group. The difference was statistically signifi-cant （t = 4.868, P = 0.000）. However, the PV-HA in the PHT group was significantly greater than that in the control group. The difference was statistically significant （t = 3.969, P = 0.000）. The HV-HA and FPP was negative correlation（r = -0.878, P = 0.000）. The PV-HA and FPP was positive correlation （r = 0.829, P = 0.000）. Though the HARI and HAPI were both positive correlated with FPP, the correlation were lower than the contrast-enhanced parameters （HARI： r = 0.658, P = 0.000; HAPI： r = 0.742, P = 0.000）. Conclusions： The correla-tion of Doppler parameters and FPP was lower. Contrast-enhanced ultmsonography parameters, such as HV-HA and the PV-HA, can sen-sitively prompt portal hypertension and the correlations with FPP were higher. Hence, they could assess the portal vein pressure mo

关 键 词：门静脉高压 超声造影 多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]