脂肪肝患者肝静脉血流多普勒频谱形态的观察

Doppler waveforms of the hepatic veins in patients with fatty liver

目的探讨脂肪肝患者肝静脉血流频谱形态特征。方法应用彩色多普勒超声对43例脂肪肝患者及38例健康者肝静脉频谱形态进行分析比较,并将脂肪肝分级与肝静脉频谱形态(分3型,T型:三相波;B型:双相波;M型:单相波)进行相关性分析。结果35例(92%)的健康对照和17例(40%)的脂肪肝患者为T型。3例(8%)健康对照和15例(35%)脂肪肝患者为B型。健康对照未见M型,脂肪肝患者中M型为11例(25%)。脂肪肝的分级与肝静脉的波形呈直线负相关(r=-0.466,P<0.05)。健康对照组与脂肪肝组之间,肝静脉频谱形态差异有统计学意义(P<0.01)。结论弥漫性脂肪肝患者中可以检出异常的肝静脉频谱(双相波和单相波),可为超声评价脂肪肝提供帮助。

Objective To investigate the characteristics of the hepatic venous Doppler waveform in the normal liver and diffuse fatty liver. Methods Forty-three patients with fatty liver and 38 normal healthy controls underwent hepatic vein duplex Doppler sonography. The correlation of the Doppler sonography spectrum of the right hepatic vein（ triphasic waveform, biphasic waveform, and monophasic waveform）and the sonographic grade of fatty liver was analyzed. Results Triphasic waveform was observed in 35 cases（92% ）of the healthy controls and 17 cases （40%）of the fatty liver patients, biphasic waveform in 3 cases （8%）of healthy controls and 15 cases （35%） of the fatty liver patients, and monophasic waveform was detected in 11 cases （25 % ）of the fatty liver patients, but not in the healthy controls. There was a statistically significant difference in the phasicity of hepatic venous flow between patients and normal controis（ P 〈0. 01 ）. A negative correlation was found between the sonographic grade of fatty liver and the phasicity of hepatic venous flow （r = - 0.466, P 〈 0.05 ）. Conclusion Abnormal right hepatic vein Doppler waveforms, biphasic and monophasic waveform, can be seen in diffuse fatty liver, which is useful for evaluating the fatty liver.