彩色多普勒超声诊断活体肝移植受体肝静脉狭窄的价值  

Application of Color Doppler Ultrasound in Evaluating Hepatic Vein Stenosis after Living Donor Liver Transplantation

作　　者：廖梅[1] 任杰[1] 郑荣琴[1] 吕艳[1] 

机构地区：[1]中山大学附属第三医院超声科,广州市510630

出　　处：《中国超声医学杂志》2014年第1期44-47,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然基金(No.30901465);中山大学青年教师培育项目(No.[2010]1)

摘　　要：目的探讨彩色多普勒超声在活体肝移植受体肝静脉狭窄中的诊断价值。方法以血管造影为金标准,将18例活体肝移植受体分为肝静脉狭窄组与对照组,比较两组的肝静脉频谱波形、肝静脉峰值流速、肝实质回声、腹水的差异。结果 18例受体中证实肝静脉狭窄4例、肝静脉通畅14例。肝静脉频谱波形、肝静脉峰值流速、大量腹水在两组间具有统计学差异(P=0.013,P=0.000,P=0.019),肝实质回声不均匀在两组间则无统计学差异(P=0.11)。狭窄组肝静脉频谱波形以持续单相波为主(3/4)、肝静脉峰值流速明显减低、大量腹水发生率增加。以肝静脉峰值流速<15.5cm/s作为肝静脉狭窄的诊断标准,灵敏度和特异度分别为99%和72%。结论活体肝移植受体术后的彩色多普勒超声检测对于诊断肝静脉狭窄具有重要的临床价值。Objective To determine the value of Color Doppler ultrasound （CDUS） in diagnosis hepatic vein ste- nosis after living donor liver transplantation （LDLT）. Methods The authors retrospectively reviewed postoperativeCDUS images of the hepatic veins in 18 consecutive patients who underwent LDLT. Patients had substantial hepatic vein stenosis （stenosis group） were conformed by angiography. Those without substantial stenosis（control group） in- cluded patients with no clinical or radiologic evidence of hepatic vein stenosis. The wave pattern and peak flow velocity of the hepatic veins,the echo of liver parenchyma and ascites were compared between the groups. Results Four pa- tients had substantial hepatic vein stenosis, 3 of 4 had persistent monophasic wave patterns,one had no persistent wave patterns. In the control group, 8 of 14 patients had a persistent triphasic or biphasic wave pattern and 1 had persistent monophasic wave patterns ; The wave pattern was significaat difference between the groups（P= 0. 013）. Peak flow velocity of the hepatic veins was significant difference between the groups （P=0. 000）. velocity of 15.5 cm/s seemed to be the most suitable compromise. The sensitivity , the specificity was 99% and 72% respectively. There were sig- nificant difference between the groups in massive ascites（P=0. 019）, and heterogeneous echo of liver parechyma was no significant difference between the groups（P = 0. 11）. Conclusions CDUS after LDLT recipients have important clinical value in the diagnosis of hepatic vein stenosis.

关 键 词：活体肝移植 肝静脉 彩色多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学]