彩色多普勒超声显像在肝移植术前的诊断价值

The Application of Color Doppler Flow Imaging on Patients Before Liver Transplantation

目的 探讨彩色多普勒超声显像在肝移植术前的诊断价值。方法 术前应用CDFI对77例欲实施肝移植病人的门静脉、肝动脉、肝静脉、下腔静脉进行检测,测量其内径、血流速度、血流方向,并检测肝肿瘤的部位、形态、大小、血管、胆道受侵情况及远处转移情况。结果 肝动脉未显示5例,2例为肝动脉变异;下腔静脉栓塞1例;门静脉栓子9例,其中血栓3例,瘤栓6例;1例将周围开放的侧支循环误认为门静脉,出现假阴性。肝肿瘤阻塞胆管引起肝内胆管扩张1例。腹膜后淋巴结肿大1例。结论 CDFI在肝移植术前能准确评估肝动脉、门静脉、下腔静脉、胆道情况,并发现远处转移情况,为临床手术提供重要依据。

Objective To evaluate the value of color Doppler flow imaging (CDFI) in patients before liver transplantation. Methods CDFI was performed on 77 patients before Liver transplantation, observing the diameter of portal vein, hepatic artery, inferior vein cava and hemodynamic data(flow velocity and direction), the ultrasonic features of liver tumor: location, size, blood supply, bile duct invasion, and metastasis were recorded. Results There were 2 cases of hepatic artery variation leading no detection of HA on ultrasound, 9 cases of portal vein embolism (thrombus in 3, tumor embolism in 6), 1 case of fasle negative detection which misdiagnose collateral circulation as normal petal vein structure, 1 case of intrahepatic biliary duct dilatation due to obstruction by liver tumor, 1 case of enlarged lymph node in retroperitoneal space. Conclusion Related structure including hepatic artery, portal vein, biliary duct and inferior vein cava could be accurately observed by CDFI before liver transplantation. In addition, metastatic tumor could also be detected . CDFI can provide meaningful information for clinical diagnosis.