超声影像诊断肝小静脉闭塞综合征的作用

The role of ultrasound imaging in diagnosis of hepatic veno occlusive syndrome

目的探讨肝小静脉闭塞综合征患者应用超声影像诊断的价值。方法选取2016年12月-2019年12月山东省高唐县人民医院收治的80例肝小静脉闭塞综合征患者为研究对象,所有患者全部通过病理和临床确诊后,给予超声影像检查,观察超声影像表现以及诊断准确率。结果在所有患者超声检查中,影像均存在肝静脉显示不清或者细窄、腹水以及不均匀的肝实质回声等。出现肝脾肿大、门静脉血流反向以及肝静脉周围带状肝回声减低等患者10例。病情较重的32例患者影像学图像表现为沿肝静脉周围带状的肝回声减低。所有患者影像学图像均可观察到肝静脉壁增厚、回声增强、肝静脉表现模糊或者细窄,患者肝静脉的流速下降,频谱形态发生改变,为门静脉样频谱。伴肝肿大的患者49例;门静脉血流反向者13例,其余67例患者的门静脉系统的血流速度下降。超声检查有75例患者结果同病理结果一致,超声检查的准确率为93.75%(75/80)。结论在肝小静脉闭塞综合征患者的诊断中,超声影像诊断可为疾病早期诊治提供准确的参考依据,具有较高的临床应用价值。

Objective To explore the value of ultrasound imaging in the diagnosis of hepatic veno occlusive syndrome.Methods A total of 80 patients with hepatic veno occlusive syndrome diagnosed and treated in Gaotang County People's Hospital of Shandong Province from December 2016 to December 2019 were selected as research subjects.After all the patients were confirmed by pathology and clinical diagnosis,ultrasound imaging examination was performed to observe the ultrasound image and the accuracy rate of diagnosis.Results In the ultrasound examination of all patients,the images showed unclear or narrow hepatic veins,ascites,and uneven liver parenchymal echo,etc.There were 10 patients with hepatosplenomegaly,portal vein blood flow reversal,and banded liver echo reduction around the hepatic veins etc.For the 32 patients with severe illness,the radiographic image showed a reduction in the echo of the liver along the bands around the hepatic veins.All patients'imaging images could observe hepatic vein wall thickening and echo enhancement,hepatic veins appeared fuzzy or narrow,the flow velocity of the hepatic veins of the patient decreased,and the spectrum shape changed,which was a portal vein-like spectrum.There were 49 patients with hepatomegaly,13 patients with reversed portal vein blood flow,and the remaining 67 patients with the blood flow velocity of the portal vein system decreased.The results of ultrasound examination were consistent with pathological results in 75 patients,and the accuracy rate of ultrasound examination was 93.75%(75/80).Conclusion In the diagnosis of patients with hepatic veno occlusive syndrome,ultrasound image diagnosis could provide accurate reference for the early diagnosis and treatment of the disease,and had high clinical application value.