探讨实时超声造影技术评价肝移植术前门静脉通畅性的研究

摘要

目的：比较目前的两种超声技术，普通超声和实时超声造影技术对肝脏移植手术前门静脉的畅通性评价特点。方法：对经普通超声技术检查后被怀疑门静脉一级分支或主干中有栓塞的34例患者进行实时超声造影检查。结果：经螺旋CT的门静脉成像、三维动态磁共振的血管成像和肝移植手术等方法的证实，34例患者中有27例门静脉栓塞患者，7例门静脉畅通患者。普通超声技术和实时超声造影技术的诊断信心评分分别为(8.32±1.89)分和(9.29±1.01)分；普通超声技术和实时超声造影技术的敏感性分别为87.9%和81.9％，特异性分别为32.8%和100%，准确性分别为68.7%和89.1%；鉴别栓子程度和栓子性质时，实时超声造影技术明显优于普通超声技术。其中，对于在实时超声造影技术中显示的16例门静脉栓塞患者，实时超声造影技术是可以百分百全部鉴别的，但在普通超声技术可以显示的17例门静脉栓塞患者中，只能鉴别出9例患者。结论：在肝移植手术前诊断门静脉的畅通性时，实时超声造影技术的诊断水平明显高于普通超声技术，能够提供更准确、丰富的术前诊断信息，实时超声造影技术可以很好地补充普通超声技术，值得临床推广应用。%Objective:To compare the two kinds of ultrasonic imaging technology,common ultrasonic and real-time contrast-enhanced ultrasound technology to the smooth general characteristic evaluation characteristic of portal vein flow preoperative liver transplantation.Method:For suspected portal vein after normal ultrasound examination level branches or trunk of 34 patients with embolization were given real-time contrast-enhanced ultrasound examination.Result:The spiral CT portal imaging,3D dynamic magnetic resonance angiography and the proof of the method such as a liver transplant confirmed,in 34 patients,there were 27 cases of portal vein thrombosis,7 cases of portal vein flow.The diagnostic confidence score of ordinary ultrasound technology and real-time contrast-enhanced ultrasound were respectively (8.32±1.89)score and (9.29±1.01)score.The sensitivity of ordinary ultrasound technology and real-time contrast-enhanced ultrasound technology were 87.9%and 81.9%respectively,the specificity were 32.8%and 100% respectively,the accuracy were 68.7% and 89.1% respectively.Identify embolus embolus and degree on the nature,real-time contrast-enhanced ultrasound technology was superior to common ultrasonic technology.Among them,for real-time contrast-enhanced ultrasound techniques could be displayed in 16 patients with portal vein thrombosis,real-time ultrasound imaging technology could be absolutely all identification.But in ordinary ultrasound could display in 17 patients with portal vein thrombosis,only 9 patients were identified.Conclusion:In the smooth operation of liver transplantation before the diagnosis of portal vein,the diagnostic level of real-time ultrasound imaging technology is obviously higher than that of ordinary ultrasonic technology,can provide more accurate and abundant preoperative diagnosis information,Real-time ultrasound imaging technology can be a good supplement ordinary ultrasonic technology,is worthy of clinical application.