彩色多普勒血流显像联合声触诊组织量化技术评价经颈静脉肝内门体静脉分流术术后疗效  

CDFI combined with virtual touch tissue quantification technique in evaluation of transjugular intrahepatic portosystemic shunt effect

作　　者：张明琼[1,2] 冉海涛[1,2] 唐茂淮[1,2] 朱叶锋[1,2] 

机构地区：[1]重庆医科大学超声影像学研究所,重庆400010 [2]重庆医科大学附属第二医院超声科,重庆400010

出　　处：《中国介入影像与治疗学》2013年第5期299-302,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金(81071157);重庆市科技攻关重点项目(2009AB5216)

摘　　要：目的探讨CDFI与声触诊组织量化(VTQ)技术评价经颈静脉肝内门体静脉分流术(TIPS)疗效的可行性。方法对24例接受TIPS的肝硬化门静脉高压患者行常规超声及CDFI检查,测量手术前后脾脏指数和门静脉及脾静脉的血流动力学参数,同时采用VTQ技术测量手术前后脾脏剪切波速度(SWV),评价TIPS疗效。结果 TIPS术后门静脉压力较术前明显降低(P<0.01);门静脉和脾静脉主干流速及流量显著增加(P均<0.01),充血指数明显减小(P均<0.01);脾脏SWV值明显减小(P<0.01);脾脏体积亦明显缩小,手术前、后脾脏指数差异有统计学意义(P<0.01)。结论 CDFI可检测TIPS前后门静脉系统及支架内血流情况,VTQ技术可无创定量检测脾脏硬度,间接反映门静脉压力;两者结合对评价TIPS疗效具有重要临床价值。Objective To explore the value of CDFI and virtual touch tissue quantification （VTQ） technique in evaluating the effect of trans）ugular intrahepatic portosystemic shunt （TIPS）. Methods Totally 24 patients of portal hypertension re- ceived TIPS underwent conventional ultrasound and CDFI to measure the splenoportal vein and hemodynamic parameters of portal, and VTQ to assess the shear wave velocity （SWV） of spleen before and after TIPS. Effect of TIPS was evaluated according to the results of CDFI and VTQ. Results After TIPS, portal vein pressure significantly decreased compared with pre-TIPS （P〈0.01）. Measured with CDFI, venous flow velocity and volume of main portal and splenic vein signifi- cantly increased and congestion index significantly decreased after TIPS （all P〈0.01）. In VTQ examination, the postoper- ative SWV of spleen decreased significantly （P〈0.01）. In addition, TIPS stent placement reduced spleen volume and there was significant difference in spleen index between pre- and post-TIPS （P〈0.01）. Conclusion CDFI can detect the blood flow of portal venous and stent before and after TIPS, while as a non-invasive method, VTQ can determine the stiffness of spleen which indicates the portal venous pressure, Combination of both techniques is of great value in clinical application for evaluation of TIPS effect.

关 键 词：门体分流术 经颈静脉肝内 高血压 门静脉 脾 声触诊组织量化 超声检查 多普勒 彩色 

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