二次谐波声学造影诊断先天性肝动脉:门静脉瘘的初步探讨

The initial investigation of second harmonic contrast imaging in diagnosis of congenital intrahepatic arterial-portal fistula

目的:探讨经静脉二次谐波声学造影诊断先天性肝动脉-门静脉瘘的可行性。方法:对4例彩色多普勒超声检查提示为先天性肝动脉-门静脉瘘患者,行经静脉二次谐波声学造影检查,并与X线血管造影对照。结果:造影剂经左前臂浅静脉注射后13～15s(平均14s)肝动脉显影,见门脉左、右支周围及其远侧有多个短条状强回声带,宽0.22～0.41cm。几乎与肝动脉显影的同时,门静脉左、右支内亦充满造影剂密集点状强回声,呈“脉冲”样反向流动。超声造影与X线血管造影结果相符。结论:经静脉二次谐波声学造影是诊断先天性肝动脉-门静脉瘘简便、准确的方法。

Objective:To investigate the possibility of intravenous second harmonic contrast imaging(ISHCI)in the diagnosis of congenital intrahepatic arterial-portal fistula(CIAPF).Methods:Four cases diagnosed as CIAPF by color Doppler ultrasound were examined with ISHCI,and results of both ISHCI and X-ray angiography were compared.Results:The arteries of liver were enhanced at 13～15s(mean 14s) after administration of contrast agents.A few“bar-like”strong echoes were seen around the left and right branches and on its distal side,with widths of 0 22～0 41cm.Almost at the same time as the arteries were enhanced,the contrast agents demonstrated dense“spot-like”strong echoes appeared in the left and right branches,flowing in an opposed direction spectroscopy.The results of ISHCI were in accordance with that of X-ray angiography.Conclusions:ISHCI is a simple and accurate method for the diagnosis of CIAPF.