实时三维超声造影评估肝移植术后肝动脉并发症的初步探讨

摘要

目的：初步探讨实时三维超声造影（RT-3D-CEUS）用于评估肝移植术后肝动脉并发症的价值。方法对2014年4月至7月在中山大学附属第三医院行肝移植的18例受者进行29例次彩色多普勒超声（彩超）、二维灰阶超声造影（2D-CEUS）和 RT-3D-CEUS 检查。RT-3D-CEUS 的成功率并评价其图像质量及诊断肝动脉并发症情况。结果29例次检查中，RT-3D-CEUS 检查成功率93％（27/29）。RT-3D-CEUS 的图像质量评分，3分14例次，2分13例次，1分2例次。采用 RT 3D-CEUS诊断肝动脉狭窄6例，其中4例为 RT-3D-CEUS 发现，后经 CTA 证实；2例在检查前已经由 CTA 或DSA 诊断肝动脉吻合口狭窄。结论RT-3D-CEUS 检查能获得直观、清晰的肝动脉图像，用于评估肝移植术后肝动脉并发症具有临床应用价值。%Objective To study preliminarily on the value of real-time three-dimensional contrast-enhanced ultrasound (RT-3D-CEUS ) for the diagnosis of hepatic artery complications after liver transplantation.Methods From April to July in 201 4,a total of 1 8 liver transplant recipients were examined 29 times,by color doppler ultrasound,contrast-enhanced ultrasound (2D-CEUS)and RT-3D-CEUS.The successful rate of RT-3D-CEUS was calculated.And the image quality and the diagnosis of hepatic artery complications were evaluated.Results In the 29 times of RT-3D-CEUS examination,the successful rate was 93% (27 /29).The image quality of RT-3D-CEUS got 3 points for 1 4 times,2 points for 1 3 times and 1 point for 2 times.In 6 cases who were diagnosed hepatic artery stenosis by RT-3D-CEUS,4 cases were first diagnosed by RT-3D-CEUS and confirmed by CTA,and 2 cases were diagnosed by CTA or DSA before RT-3D-CEUS.Conclusions The RT-3D-CEUS examination can get intuitive and clear images,which has clinical application value in evaluating hepatic artery complications after liver transplantation.