高频彩色多普勒超声在诊断小儿胆道闭锁中的应用

Application of high frequency color Doppler ultrasound in the diagnosis of biliary atresia in children

目的分析儿童胆道闭锁中的超声图像特征,探讨高频彩色多普勒超声在早期诊断胆道闭锁中的应用价值。方法回顾性分析46例经手术及病理确诊的胆道闭锁患儿术前超声图像资料,结合术中病理结果,分析高频彩色多普勒超声时提示肝脏大小及内回声情况,胆囊显示率及胆囊大小、形态,肝门区结构,肝动脉内径及血流频谱特征的作用,评估其早期诊断价值。结果术前超声提示肝脏形态增大,肝内回声改变24例(52%),胆囊长径<15mm 20例,胆囊长径>15mm 18例,胆囊未显示2例,胆囊显示欠清(考虑裂隙样胆囊)6例。超声提示肝门部纤维块42例,2例MRI提示胆道闭锁,2例超声提示肝门部小囊腔。肝动脉内径2.2~2.8mm,均值2.4mm。肝动脉频谱为高速高阻血流,PSV:77~123cm/s,RI:0.89~0.96。结论胆囊形态及肝门部纤维块是超声诊断胆道闭锁的重要征象,综合分析肝脏形态及肝动脉内径与频谱特征对早期诊断小儿胆道闭锁具有一定价值。

Objective To analyze the ultrasound imaging characteristics of infantile biliary atresia,and to discusses high frequency colour ultrasound imaging in the early diagnosis of biliary atresia. Methods 46 cases confirmed by surgery and pathology were retrospectively analyzed biliary atresia with preoperative ultra-sound image data,combinedwith intraoperative and pathological findings,Comprehensive analysis of ultrasound in liver size and inner conditions of the echo,the detection rate of gallbladder and gallbladder size and shape, liver mun structure,hepatic artery diameter and blood flow spectrum features,and evaluate the early diagnostic value.Results Preoperative ultrasound showed increase liver morphology,24 cases （52%）of the echo change in the liver.There are 2 cases ofGallbladder is notdisplayed,6 cases of gallbladder show less clear （with crack sample gallbladder）,20 cases of gallbladder length to diameter 〈15 mm with,and 18 cases of gallbladder length to diameter 〉15 mm children.Ultrasonic indicated that liver fiber piece of 42 cases of portal vein,2 cases MRI suggested biliary atresia,2 cases of ultrasonic hint antrum of hepatic portal vein capsule.He-patic artery diameter 2.2 -2.8 mm,the average of 2.4 mm.Hepatic arterial spectrum for high-speed,high re-sistance of blood flow,PSV：77 -123 cm/s,RI：0.89 to 0.96. Conclusions Gallbladder morphology and hepatic portal vein fiber is one of the important signs of ultrasonic diagnosis of biliary atresia,integrated appli-cation of the liver and hepatic artery diameter and spectrum characteristics has certain value for early diagnosis of infantile biliary atresia.