肝移植术后肝动脉狭窄频谱Tardus Parvus波形和超声造影微灌注定量技术的临床价值  

Clinical value of Tardus Parvus waveform and contrast-enhanced ultrasound microperfusion quantitative technique in hepatic artery stenosis after liver transplantation

作　　者：赵宁波 冯文霞 邓芬 董常峰[3] 周鹏[2] 贡雪灏 ZHAO Ning-bo;FENG Wen-xia;DENG Fen;DONG Chang-feng;ZHOU Peng;GONG Xue-hao(Guangzhou Medical University,Guangzhou 510180,China;Shenzhen Second People's Hospital,Shenzhen 518035,Guangdong Province,China;Shenzhen Third People's Hospital,Shenzhen 518020,Guangdong Province,China)

机构地区：[1]广州医科大学,广州510180 [2]深圳市第二人民医院,广东深圳518035 [3]深圳市第三人民医院,广东深圳518020

出　　处：《中国临床解剖学杂志》2020年第6期723-727,共5页Chinese Journal of Clinical Anatomy

基　　金：深圳市科技创新委员会(JCYJ20170413161913429);深圳市医疗卫生三名工程(SZSM201612027)。

摘　　要：目的探讨肝移植术后肝动脉狭窄频谱Tardus Parvus波形和超声造影微灌注定量技术的临床意义。方法收集60例肝移植术后病人的相关影像资料,记录肝动脉多普勒超声的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)及加速时间(SAT)等参数,Tardus Parvus波形的诊断标准为RI<0.5且SAT>0.8 s;超声造影分别记录肝边缘区域和中心区实质基础强度(BI)、到达时间(AT)、峰值强度(PI)、达峰时间(TTP)及中心区域与边缘区域的实质增强程度差异绝对值(REI)等定量参数,以CTA或DSA诊断肝动脉直径狭窄率≥50%为标准,将患者分为肝动脉狭窄组和非狭窄组。结果肝动脉狭窄组多普勒超声表现为Tardus Parvus波形阳性(P<0.05),超声造影狭窄组与非狭窄组相比,REI减小(P<0.05),中心区域TTP延长(P<0.05)。结论 Tardus Parvus波形和超声造影微灌注定量技术对肝移植术后肝动脉狭窄诊断具有一定的价值。Objective To explore the clinical value of Tardus Parvus waveform and contrastenhanced ultrasound(CEUS) microperfusion quantitative technique in hepatic artery stenosis after liver transplantation. Methods Sixty cases of liver transplantation patients of hepatic artery doppler ultrasound,ultrasonic imaging and CTA/DSA examination data were collected separately. The systolic peak of hepatic artery doppler ultrasound blood flow velocity(PSV), end-diastolic velocity(EDV), resistance index(RI),acceleration time(SAT) were recorded. Tardus Parvus waveform of the diagnostic criteria were RI < 0.5 and SAT > 0.8 s. Contrast-enhanced ultrasound was used to record quantitative parameters such as marginal region of liver and central region basic identity(BI), arrival time(AT), peak intensity(PI), time to peak(TTP),absolute value of difference in real enhancement identity(REI) between the central region and the marginal region. Patients were divided into two groups according to the standard of hepatic artery stenosis rate ≥ 50%diagnosed by CTA or DSA: a hepatic artery stenosis group and a non-stenosis group. Results Doppler ultrasound in the hepatic artery stenosis group showed positive Tardus Parvus waveform(P<0.05). Compared with the non-stenosis group, absolute value of difference in REI between the central region and the marginal region reduced(P<0.05), and TTP in the central region prolonged(P<0.05). Conclusions Tardus Parvus waveform and contrast-enhanced microperfusion quantitative technique have a certain value in the diagnosis of hepatic artery stenosis after liver transplantation.

关 键 词：肝移植 肝动脉狭窄 Tardus Parvus波形 超声造影微灌注定量技术 

分 类 号：R657.3[医药卫生—外科学] R445.1[医药卫生—临床医学]