放射性肝损伤彩色多普勒超声的表现特征及影响因素  

Study on the characteristics and influencing factors of color Doppler ultrasound in radiation-induced liver injury

作　　者：吴雪云 刘真[1] WU Xue-yun;LIU Zhen(Department of Medical Imaging,Huizhou Occupational Disease Prevention and Control College,Huizhou,Guangdong 516001,China)

机构地区：[1]惠州市职业病防治院医学影像科,广东惠州516001

出　　处：《中国卫生工程学》2023年第1期45-47,共3页Chinese Journal of Public Health Engineering

基　　金：惠州市科技局(2020Y092)。

摘　　要：目的探讨放射性肝损伤彩色多普勒超声的表现特征及影响因素。方法选取2018年1月至2020年10月在本院接受放疗的200例腹部恶性肿瘤患者纳入研究,入选患者均行计算机断层扫描(CT)、彩色多普勒超声检查,以临床综合诊断结果为参照,比较CT与彩色多普勒超声对腹部恶性肿瘤患者放射性肝损伤的诊断结果,分析放射性肝损伤的彩超表现特征,探讨彩色多普勒超声诊断放射性肝损伤的影响因素。结果200例入选患者中有40例经临床综合诊断确诊放射性肝损伤。以临床综合诊断结果参照,彩色多普勒超声对腹部恶性肿瘤患者放射性肝损伤的诊断灵敏度、特异度、阳性预测值、阴性预测值与CT之间比较差异均无统计学意义(均P>0.05);但彩色多普勒超声对放射性肝损伤的诊断准确率(94.50%)低于CT(98.50%),差异有统计学意义(χ^(2)=4.737,P<0.05)。CT、彩色多普勒超声诊断放射性肝损伤的结果与临床综合诊断结果之间的一致性均较高。放射性肝损伤患者的彩色多普勒超声图像中可见增粗光点,内部回声信号增强,有条状或网格状回声,肝内血管壁增厚,血管走行扭曲,血管内血流充盈欠佳。肝损伤患者收缩期最大流速[(3.58±1.17)vs(5.49±1.74)cm/s;t=6.574,P=0.000]、舒张末期流速[(11.25±2.74)vs(14.37±3.08)cm/s;t=5.852,P=0.000]均小于无肝损伤患者,而阻力指数[(0.76±0.15)vs(0.61±0.13),t=6.324,P=0.000]、搏动指数[(0.95±0.18)vs(0.78±0.16);t=5.859,P=0.000]均高于无肝损伤患者,差异均有统计学意义(均P<0.05)。结论彩色多普勒超声对放射性肝损伤的诊断价值较高,但其诊断准确性可能会受到医师主观因素、图像清晰度的影响。Objective This study was designed to investigate the characteristics and influencing factors of color Doppler ultrasound in radiation-induced liver injury.Methods From January 2018 to October 2020,200 patients with abdominal malignant tumor who received radiotherapy in our hospital were included in the study,and the patients were given computed tomography to compare the diagnostic results of CT and color Doppler ultrasound on radiation-induced liver injury in patients with abdominal malignant tumor,the color Doppler ultrasound features of radiation-induced liver injury and the influencing factors of color Doppler ultrasound in the diagnosis of radiation-induced liver injury were analyzed.Results Of the 200 selected patients,40 were diagnosed as radiation liver injury by clinical comprehensive diagnosis.According to the clinical comprehensive diagnosis results,there was no significant difference between the sensitivity,specificity,positive predictive value,negative predictive value of color Doppler ultrasound and CT in the diagnosis of radioactive liver injury in patients with abdominal malignant tumors(all P>0.05);However,the diagnostic accuracy of color Doppler ultrasound in radiation-induced liver injury(94.50%)was lower than that of CT(98.50%),and the difference was statistically significant(χ^(2)=4.737,P<0.05).The results of CT and color Doppler ultrasound in the diagnosis of radiation-induced liver injury were consistent with the results of clinical comprehensive diagnosis.In the color Doppler ultrasound image of patients with radiation liver injury,there were thickened light spots,enhanced internal echo signal,strip or grid echo,thickening of intrahepatic blood vessel wall,twisting of blood vessels,and poor blood flow filling in the blood vessels.The maximum systolic flow rate in patients with liver injury[(3.58±1.17)vs(5.49±1.74)cm/s;t=6.574,P=0.000],end-diastolic flow velocity[(11.25±2.74)vs(14.37±3.08)cm/s;t=5.852,P=0.000]were smaller than those without liver injury,while the resistance index[(0.76�

关 键 词：放射性肝损伤 彩色多普勒超声 诊断 影响因素 

分 类 号：R445.1[医药卫生—影像医学与核医学]