超声造影、术中超声在肝移植术后血管并发症中的应用

Application of contrast-enhanced ultrasound and intraoperative ultrasound in vascular complications after liver transplantation

目的探讨超声造影、术中超声在肝移植术后血管并发症中的诊断价值。方法对CDFI检查疑有肝动脉、门静脉及下腔静脉狭窄或血栓形成的9例患者进行超声造影检查,对疑有门静脉血栓的3例患者进行术中超声检查;检查结果与数字减影血管造影(DSA)进行对照分析。结果超声造影提示门静脉血栓形成3例,并经术中超声检查证实肝动脉血栓形成3例,下腔静脉狭窄1例,均经DSA证实。另2例超声造影提示肝动脉未见明显异常的患者中,1例DSA诊断为肝动脉狭窄,1例肝动脉无明显异常;超声造影诊断符合(7/9)。结论超声造影可确诊门静脉、肝动脉血栓,但对准确诊断肝动脉狭窄仍有一定困难。

Objective To investigate the diagnostic value of contrast-enhanced ultrasound （CEUS） and intraoperative ultrasound （IOUS） in vascular complications after liver transplantation. Methods Nine cases who were suspected of hepatic artery, portal vein and inferior vena cava stenosis or thrombosis by CDFI underwent CEUS examination. 3 of them with suspected portal vein thrombosis underwent IOUS,the results were compared with those of DSA. Results CEUS showed 3 cases of portal vein thrombosis, 3 cases of hepatic artery thrombosis, 1 case of inferior vena cava stenosis. In the other 2 cases, CEUS showed no abnormality of hepative artery, while DSA showed hepative artery stenosis in 1 case,the other 1 case was no obviously abnormal. The diagnosis coincidence rate of CEUS was 7/9 in vascular complications after liver transplantation. Conclusion CEUS can comfirm the thrombosis in portal vein and hepatic artery, but it still has certain difficulty for accurate diagnosis of hepatic artery stenosis.