三维能量多普勒对肝炎孕妇肝脏灌注的评估价值

Assessment of Liver Perfusion in Hepatitis Pregnant Women by Three-dimensinal-sonography Power Doppler Vascular Indexes

目的应用三维彩色能量多普勒超声成像（3D-CPA）评估妊娠13--41孕周乙型肝炎（乙肝）孕妇的肝脏灌注的价值。方法选取2012年2月-2013年6月孕检的13--41孕周孕妇117例,其中乙肝孕妇73例和健康孕妇44例。在孕妇肝右叶门静脉分支附近进行采样,通过虚拟组织计算机辅助分析软件（VOCAL）分析获得血管化指数（VI）、血流指数（FI）、血管化血流指数（VFI）。比较乙肝孕妇与健康孕妇的肝脏灌注差异。结果乙型肝炎病毒（HBV）-DNA病毒载量组和对照组之间由3D-CPA获得的肝脏血管指数差异有统计学意义（P〈0.05）,3个血管指数的临界值分别为：VI=8.760（P〈3×10-4）、FI=22.180（P〈6×10-7）、VFI=1.575（P〈3×10-5）。结论应用3D-CPA评估肝脏灌注可以分辨感染HBV的孕妇与健康孕妇,在一定程度上为临床预防和治疗孕妇感染HBV提供帮助。

Objective To evaluate liver perfusion in pregnant women with hepatitis between 13 and 41 weeks of gestation by three-dimensional color power Doppler angiography （3D-CPA） vascular indexes. Methods This study involved 73 pregnant women with hepatitis and 44 healthy pregnant women who had the pregnancy examination between February 2012 and June 2013. We sampled in the area which was near the right lobe of the pregnant women liver＇s portal vein branch, and obtained the vascularization index （VI）, flow index （FI） and vascularization flow index （VFI） via the virtual organ computer-aided analysis （VOCAL） method. Then, we compared the liver perfusion differences between the pregnant women with hepatitis and healthy pregnant women. Results The hepatic flow indexes obtained by 3D-CPA were significantly different between the HBV-DNA viral load and the control groups. The cutoff values of the three vascular indexes of patients with hepatitis with HBV-DNA viral load and the healthy pregnant women were respectively VI=8.760 （e 〈 3×10-4）; FI=22.180 （P 〈 6×10-7）; and VFI=1.575 （P 〈 3× 10-5）. Conclusion Application of the 3D-CPA on liver perfusion may differentiate pregnant women with hepatitis B from normal ones, thus offer a support for clinical prevention and treatment for pregnant women with hepatitis B.