声学造影在肝移植术后门静脉血栓、癌栓和狭窄中的应用

Contrast enhanced ultrasonography in cancer emboli, thrombosis and stenosis of the portal vein after the liver transplantation

目的探讨声学造影在肝移植术后门静脉血栓、癌栓和狭窄中的应用价值.方法对11例肝移植术后门静脉超声检查异常的患者进行声学造影.造影剂声诺维（SonoVue）,用量2.0～2.4 ml,对比脉冲序列（CPS）成像模式,采用肘静脉快速团注法.结果移植肝门静脉癌栓3例,表现为注射造影剂后在肝动脉显影后大约10～15 s门静脉负显影区内出现点状、细线样造影剂充填,持续约58～78 s;移植肝门静脉血栓4例,表现为注射造影剂后门静脉附壁或低回声区内始终为造影剂充盈缺损;移植肝门静脉狭窄1例,表现为注射造影剂后门静脉吻合口造影剂充填内径为2.4 mm;移植肝门静脉正常3例,表现为注射造影剂后门静脉充填完整.结论声学造影可明确诊断肝移植术后门静脉血栓、癌栓和狭窄.

Objective To study the value of contrast enhanced uhrasonography in distinguishing cancer emboli, thrombosis and stenosis in the portal vein after the liver transplantation. Methods Eleven patients with abnormal ultrasound in portal vein after liver transplantation were examined by Philip IU22 and Sequoia 512, injecting microbubble contrast agent （SonoVue） 2.0-2.4 ml by bolus rapidly through cubital vein by a low mechanical index technique （cadence contrast pulse sequencing）. Results The dots or thread-line filling appeared in thrombi at 15-30 s after hepatic artery imaging in 3 cases with cancer thrombi of the portal vein, which last about 58--78 s; No filling images were found in portal vein after injecting contrast agent in 4 cases with complete portal vein thrombosis; the filling defect was seen in 1 case with portal vein stenosis （opening diameter only 2. 4 mm） ; and complete filling imagings were demonstrated in 3 cases with normal of the portal vein.. Conclusion Contrast-enhanced uhrasonography can contribute to distinguishing portal vein cancer emboli, thrombosis and stenosis after liver transplantation.