彩色多普勒超声联合ARFI诊断菊叶三七至肝小静脉闭塞病的价值
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南京大学医学院附属南京鼓楼医院,南京大学医学院附属南京鼓楼医院

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南京市医学发展重点项目(ZKX14017)


Acoustic radiation force impulse imaging combined with CDFI in evaluation of patients with hepatic veno-occlusive disease after taking Gynura segetum
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Department of Ultrasound,Drum Tower Hospital,The Affiliated Hospital of Nan Jing University Medical School,Department of Ultrasound,Drum Tower Hospital,The Affiliated Hospital of Nan Jing University Medical School

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    摘要:

    目的 探讨ARFI联合彩色多普勒超声对HVOD的诊断价值。 方法 运用ARFI技术和彩色多普勒超声分别对30例健康志愿者及29例HVOD患者进行检查,测量和观察门静脉、脾静脉、肝静脉内径、最大流速及频谱形态,ARFI成像检测肝、脾的剪切波速度,比较两组的差异并分析HVOD组的超声特征。 结果 病例组肝脏呈“斑片状”改变有25例(86%),脾脏体积正常23例(80%),门静脉频谱形态异常26例(89.6%),肝静脉频谱形态异常17例(58.6%),门静脉、脾静脉内径在正常对照组与病例组间无统计学差异(P>0.05),病例组门静脉流速、脾静脉、肝静脉管径及流速均较正常对照组减低,二者差异均有具有统计学意义(P<0.05);病例组肝、脾SWV值明显高于正常对照组,二者差异均有具有统计学意义(P<0.001)。 结论 ARFI联合彩色多普勒超声为HVOD提供了更加丰富的诊断依据,具有重要的诊断价值,同时也可作为治疗后随访和无创评估疗效的重要检测手段。

    Abstract:

    Purpose: To explore the value of acoustic radiation force impulse (ARFI) imaging and CDFI in evaluating the effect of hepatic veno-occlusive disease (HVOD) after taking Gynura segetum.Materials and Methods: we prospectively measured stiffness of the liver and spleen with mean shear wave velocity (SWV, m/s) on ARFI imaging in 30 healthy volunteers and 29 patients of HVOD. Portal vein, right hepatic vein and splenic vein were evaluated by Doppler ultrasound, diameters and maximum velocities were measured and compared. We performed 5 shear-wave measurements in the liver and spleen, mean values were calculated. Results: B-mode sonography revealed patchy hypoechoic parenchymal areas (86%), thin hepatic veins (58.6%) and normal spleen (80%). The incidence of abnormal spectral in portal vein (89.6%) and right vein (58.6%) is high. A significant decline in the velocity of blood ?ow in portal veins , splenic vein and right hepatic veins were found in the HVOD cases as compared to those in the healthy controls. In addition, we observed a significant difference in diameter of hepatic vein between healthy subjects and patients with HVOD(P<0.05). The mean liver and spleen stiffness value in healthy controls was significantly lower than in patients with HVOD(P<0.001). There was no significant differences in diameter of portal vein and splenic vein between healthy subjects and patients with HVOD(P>0.05).Conclusion: CDFI can detect the change of blood vessel diameter and flow velocity, ARFI can detect the change of liver and spleen stiffness of patients. CDFI combined with ARFI have a higher value in clinical application for noninvasive diagnosis of HVOD.

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杨建,诸葛宇征.彩色多普勒超声联合ARFI诊断菊叶三七至肝小静脉闭塞病的价值[J].临床超声医学杂志,2016,18(9):597-600

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  • 收稿日期:2016-03-16
  • 最后修改日期:2016-03-16
  • 录用日期:2016-03-23
  • 在线发布日期: 2016-10-11
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