常规超声及超声造影评估肝移植供肝质量的临床价值

Clinical value of conventional ultrasound and contrast-enhanced ultrasound in evaluating donor liver quality in liver transplantation

目前等待肝移植的终末期肝病患者众多,快速、简便、无创、准确地评估供肝质量,对改善肝移植受者的预后和生存质量具有重要意义。临床上尚没有统一的供肝质量评估标准,大多采用综合评估的方法,包括供者的临床指标、实验室检查、影像学检查以及病理学检查等。常规超声及超声造影可在肝移植术前评估供肝质量及预测肝移植术后并发症的发生情况,在肝移植中具有较好的应用前景。本文总结了常规超声及超声造影在评估供肝血管变异、供肝实质微循环灌注、供肝脂肪变性程度、供肝纤维化程度、供肝体积与质量等方面的基本方法和研究进展,为临床供肝质量评估提供更多的方法与思路。

At present,a large quantity of patients with end-stage liver diseases are still waiting for liver transplantation.Evaluation of donor liver quality with rapid,convenient,non-invasive and accurate methods plays a pivotal role in improving the prognosis and quality of life of liver transplant recipients.No standard evaluation criteria of donor liver quality have been established in clinical practice.Comprehensive evaluation methods have been primarily adopted,including clinical parameters of donors,laboratory examination,imaging examination and pathological examination,etc.Conventional ultrasound and contrast-enhanced ultrasound may evaluate the quality of donor liver before liver transplantation and predict the incidence of complications after liver transplantation,which are of significant application prospect in liver transplantation.In this article,the basic methods and research progress on conventional ultrasound and contrast-enhanced ultrasound in evaluating the vascular variation of donor liver,micro-circulatory perfusion of liver parenchyma,degree of steatosis of donor liver,degree of fibrosis of donor liver,volume and quality of donor liver were reviewed,aiming to provide more methods and ideas for clinical evaluation of donor liver quality.