超声造影对下腔静脉梗阻型布加氏综合征的诊断价值

Clinical Value of Contrast-enhanced Ultrasound in the Diagnosis of Budd-Chiari Syndrome with Inferior Vena Cava Obstruction

目的探索超声造影技术对下腔静脉梗阻型布加氏综合征的诊断价值。方法对38例下腔静脉梗阻型布加氏综合征患者血管介入治疗前后行超声造影检查,观察下腔静脉的血流灌注特点。超声造影结果与血管造影对比分析。结果超声造影后能清楚显示下腔静脉的梗阻部位及程度,闭塞处局部无增强,狭窄处局部血流形态变窄,治疗后闭塞及狭窄处血流灌注改善,可见造影剂通过或血流增宽。介入治疗前下腔静脉肝后段显影延迟(32±11)s,延迟时间与下腔静脉压力呈正相关(P<0.05),治疗后下腔静脉内压力下降,下腔静脉肝后段显影时间明显缩短(11±5)s(P<0.05)。结论低机械指数实时灰阶超声造影技术能准确判定下腔静脉血管狭窄及闭塞的部位和类型,有助于手术方式的选择以及术后疗效的判断。

Objective To explore the clinical value of contrast-enhanced ultrasound(CEUS)in the diagnosis of Budd-Chiari syndrome with inferior vena cava(IVC)obstruction.Method A total of 38 patients with Budd-Chiari syndrome with IVC obstruction were examined by CEUS before and after vascular interventional management,and the results were compared with angiographic findings.Results The location and degree of IVC obstruction were clearly showed on CEUS.Enhancement was found in the occlusion site,and blood flow was narrowed at the stenosis site.The arrival time was earlier after treatment in the IVC obstruction,and it was positively correlated with the pressure of IVC(P < 0.05).Conclusion The location and type of the occlusion and stenosis in IVC can be accurately determined by CEUS.Therefore,CEUS can provide useful information for the selection of surgical procedures and post-operative effectiveness.