超声造影评估门静脉通畅性的适应证探讨

Indication of contrast-enhanced ultrasound in evaluating of portal vein patency

目的 评估常规超声和超声造影（CEUS）在门静脉通畅性诊断中的实用性及CEUS适应证.方法 比较不同声窗条件下常规超声和CEUS对64例门静脉通畅性的诊断水平.根据常规超声门静脉观测声窗条件的好坏分为3级：1级,声窗条件好;2级,声窗条件欠佳;3级,声窗条件差.结果 64例中证实门静脉栓塞35例,门静脉通畅29例.在诊断门静脉通畅性方面,常规超声和CEUS总体诊断准确性分别为76.6%和92.2%.声窗条件好时,常规超声和CEUS的诊断准确性相当,分别为93.1%、96.6%;声窗条件欠佳时,CEUS的诊断准确性较常规超声提高31.2%（87.5%对56.3%）;声窗条件差时,CEUS的诊断准确性较常规超声提高21.1%（89.5%对68.4%）.结论 在声窗条件好、门静脉显示清晰的条件下,常规超声诊断门静脉血流通畅性的准确程度与CEUS相当,并不一定需要行造影检查.若不具备上述条件,CEUS是值得推荐的.

Objective To evaluate the usefulness of baseline ultrasound（BUS） and contrast-enhanced ultrasound（CEUS） in diagnosis of portal vein（PV） patency and to explore the indication of CEUS. Methods The diagnostic capability of BUS and CEUS were assessed in 64 cases according to definition of PV on BUS,which was divided into high, moderate and low definition. Results Thirty-five patients with portal vein thrombosis（PVT） and 29 patients with normal portal vein were confirmed. The diagnostic accuracies by using BUS and CEUS were 93.1% and 96.6% with high definition of PV,56.3% and 87.5% with moderate definition,and 68.4% and 89. 5% with low definition, respectively. Conclusions In the case of high definition of PV,the validity of diagnosing of PV patency with BUS may be similar to that with CEUS,thus introduction of CEUS would probably not be necessary. Otherwise CEUS is recommended.