彩色多普勒超声对特发性门静脉高压症的诊断价值

Significance of color Doppler in diagnosis of idiopathic portal hypertension

目的探讨彩色多普勒超声对特发性门静脉高压症的诊断价值。方法应用彩色多普勒超声对15例特发性门静脉高压症患者进行检查,观察肝脏表面,内部回声,脾脏大小,肝门静脉及分支以及脾静脉等。结果二维灰阶超声显示15例特发性门静脉高压症中11例均出现不同程度的肝实质回声增粗,但均未见表面凹凸不平表现。15例(15/15)均见门静脉肝内分支管壁增厚、回声增强、管腔狭窄甚至闭塞呈条索状高回声。3例(3/15)伴有门静脉主干及脾静脉迂曲扩张,7例(7/15)伴有门静脉主干狭窄,显示门静脉主干管壁增厚、回声增强,管腔狭窄。彩色多普勒超声显示沿狭窄闭塞的肝内门静脉分支走行探及少许断续的点状血流。9例(9/15)出现门静脉海绵样变性。结论彩色多普勒超声显示肝内门静脉分支管壁增厚、管腔狭窄甚至闭塞的特征性改变及门静脉海绵样变性等,可提示为特发性门静脉高压症,彩色多普勒超声在特发性门静脉高压症诊断上有较高的临床应用价值。

Objective To probe the value of color Doppler in the diagnosis of idiopathic portal hypertension(IPH).Methods Fifteen cases with IPH were detected by color Doppler.The surface,interior echoes,size of spleen and portal veins and their branches and spleen vein were observed.Results B-mode ultrasound showed 11 cases of 15 cases displayed coarse liver parenchyma,with even surface.In 15(15/15)cases,intrahepatic portal vein appeared thickened wall,enhanced echoes,or occlusion presenting strip-like and funicular strong echoes and color Doppler detected only a few,punctate flow in intrahepatic portal vein.Main portal vein and spleen vein showed distorted and dilated in 3 cases(3/15).Main portal vein showed thickened wall,enhanced echoes and stenotic in 7(7/15)cases.Cavernous degeneration in potal vein appeared in 9(9/15)cases.Conclusions As coarse liver parenchyma with even surface,splenomegaly,portal vein trunck dilatation,thickened enhanced wall,stenosis or occlusion of intrahepatic portal vein with strip-like and funicular venous flow and portal vein degeration were appeared,the diagonsis of IPH would be suggested.CDFI is worthy for the diagnosis of the disease.