超声造影在肝移植术后并发症中的应用

Application of contrast-enhanced ultrasound in the complications after liver transplantation

目的探讨超声造影在肝移植术后并发症中的应用价值。方法对26例彩色多普勒超声检查结果异常或可疑病变的肝移植患者进行超声造影。造影剂（Sono Vue）用量2．4ml，机械指数0．06～0．08，采用肘静脉或术中静脉留置管快速团注，14例患者注射1次，10例患者注射2次，2例患者注射3次，记时器与录像机同步记录。结果移植肝肝癌复发6例，移植肝门静脉癌栓2例、血栓4例，移植肝肝硬化再生结节3例，移植肝肝动脉扭曲、重叠、侧支循环形成2例，移植肝脂肪肝伴坏死1例；移植肝血肿1例，移植肝未见异常7例。21例得到手术病理、穿刺活检的证实，5例与其他影像学检查结果一致。结论超声造影可协助诊断肝移植术后主要并发症，尤其能鉴别门脉内的血栓和癌栓，鉴别肝癌复发与血肿和脂肪坏死。

Objective To study the value of contrast-enhanced ultrasound in the complications after liver transplantation. Methods Twenty-six liver transplantation patients with abnormal or suspicious routine sonographic findings were underwent examination of contrast-enhanced ultrasound, with a bolus injection of SonoVue at dose of 2.4 ml. The study was performed by using Philips IU22 system with MI between 0.06 to 0.08. Results There were several positive findings, such as transplantation-liver hepatocelullar carcinoma 6 cases, transplantation-liver portal vein cancer emboli 2 cases, thrombosis 4 cases, transplantation-liver cirrhosis 3 cases, transplantation-liver hepatic artery deformity 2 cases, transplantation-liver fatty degeneration and necrosis 1 cases, transplantation-liver hematoma 1 cases, transplantation-liver normal 7 cases. Twenty-one contrast-enhanced results were confirmed by pathology, five were showing no difference with CT, MRI or DSA. Conclusions Contrast-enhanced ultrasound can contribute to diagnosing hepatic vessel complications after liver transplantation, especially distinguishing portal vein cancer emboli from thrombosis. It is also useful for differential diagnosis of liver solid lesion, such as hepatocellular carcinoma, local fatty liver and hematoma.