彩色多普勒超声诊断肝内门-体静脉分流价值探讨  

Application of color Doppler ultrasound in diagnosis of patients with intrahepatic portosystemic venous shunt

作　　者：吴碧君[1] 谢佳佳[2] 周苏晋[1] 王金霞[1] 黄红艳[1] 崔楠[1] 

机构地区：[1]广东省第二人民医院超声科,广州市510317 [2]广东省第二人民医院心血管内科,广州市510317

出　　处：《实用肝脏病杂志》2015年第4期391-394,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金青年项目(编号:81401426)

摘　　要：目的 探讨彩色多普勒超声检查肝内门-体静脉分流（IPSVS）的特征及诊断价值。方法 使用Philips IE33或GE LOGIQ9彩色多普勒超声诊断仪（凸阵探头,频率3.5～5.0 MHz）检查14例IPSVS患者,总结其肝脏超声图像特征及临床资料。所有患者经行多层螺旋CT检查并诊断为IPSVS。结果 在14例存在肝内门静脉分支与体循环静脉分支直接交通者中,男6例,女8例,年龄43～70岁;1例为结肠癌并发肝内多发转移,2例为肝功能异常,8例为非肝脏疾病就诊的患者,3例为乙型肝炎肝硬化;本组病变位于右肝12例（85.7%）,明显多于左肝2例[14.3%,P〈0.01];按Park分型,Ⅱ型5例（35.7%）,Ⅲ型9例（64.3%）;超声表现为肝内囊状或迂曲管道状无回声,与门静脉、肝静脉相通,彩色多普勒显示其内为红蓝两色交替或迂曲的血流信号,血流方向为从门静脉至肝静脉。结论 彩色多普勒超声能够敏感地发现异常血流并可测定血流方向、流速、流量,是IPSVS的首选诊断方法。Objective To investigate the diagnostic value of color Doppler ultrasound in patients with intra- hepatic portosystemic venous shunts （IPSVS）. Methods Philips IE33 and GE LOGIQ9 color Doppler ultrasound was applied for liver examination. Results Fourteen patients（six men and 8 women with age of 43 to 70 yr-old） were recruited in our series. Out of them,one with hepatic metastasis from colon,two with abnormal liver function tests with unknown causes,three with liver cirrhosis, and eight with extrahepatic diseases;IPSVS manifested a- neurysmal or tubular communication from portal vein to hepatic veins and 12 （85.7%） were found having IPSVS located in right lobe of liver,and 2（14.3%,P〈0.01）in left liver;According to Park classification,type Ⅱ were found in 5 （35.7%）and type Ⅱ in 9 （64.3%,P〈0.01）;Color Doppler imaging showed alternating red and blue or circuitous blood flow signals in the shunts. Conclusion Color Doppler ultrasound can sensitively determine the blood flow direction,flow velocity and flow volume of IPSVS.

关 键 词：肝内门-体静脉分流 彩色多普勒超声 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]