彩色多普勒超声检测在酒精性肝病诊断中的应用

Application of Color Doppler Ultrasonography in Diagnosis of Alcoholic Liver Disease

目的:分析彩色多普勒超声检测在酒精性肝病(ALD)类型诊断中的应用价值,以期为疾病诊治提供可靠依据。方法:回顾性选取济南市历下区人民医院消化内科2019年1月-2021年1月临床确诊为ALD的患者98例,均进行了彩色多普勒超声检测。分析诊断准确率及超声图像特点。结果:临床诊断酒精性脂肪肝26例,酒精性肝炎19例,酒精性肝纤维化12例,酒精性肝硬化41例。彩色多普勒超声诊断酒精性脂肪肝、酒精性肝炎、酒精性肝纤维化、酒精性肝硬化准确率分别为84.61%(22/26)、89.47%(17/19)、91.67%(11/12)、97.56%(40/41)。酒精性脂肪肝超声图像显示肝脏轻度或中度增大,包膜光滑平整,边界较清晰。酒精性肝炎超声图像显示肝细胞水肿,肝脏增大或正常,包膜不光滑,肝实质回声增强且不均匀。酒精性肝纤维化超声图像显示肝内纤维组织增生,肝脏增大明显,边缘变钝,肝实质回声增高、增粗,且不均匀。酒精性肝硬化超声图像显示肝小叶结构破坏,纤维组织增生,边界较清晰,包膜增厚,肝实质回声密集增强且弥漫分布。结论:将彩色多普勒超声检测用于ALD诊断中,可清晰显示肝的损害情况,是一种有效的影像学检查手段之一,用于辅助鉴别ALD具有一定价值,有助于临床医师尽快诊断肝病类型并制定相应治疗措施,值得临床推广。

Objective:To analyze the value of color Doppler ultrasound detection in the diagnosis of alcoholic liver disease(ALD),in order to provide reliable basis for disease diagnosis and treatment.Method:A total of 98 patients with clinically confirmed ALD in the department of gastroenterology of Jinan Lixia District People’s Hospital from January 2019 to January 2021 were selected for color Doppler ultrasound detection.The diagnostic accuracy and ultrasonic image characteristics were analyzed.Result:Among 98 ALD patients,26 cases were alcoholic fatty liver,19 cases were alcoholic hepatitis,12 cases were alcoholic liver fibrosis and 41 cases were alcoholic cirrhosis by clinically confirmed.The accuracy rate of Doppler ultrasound detection for alcoholic fatty liver,alcoholic hepatitis,alcoholic liver fibrosis,and alcoholic cirrhosis were 84.61%(22/26),89.47%(17/19),91.67%(11/12),97.56%(40/41)respectively.Ultrasonoscopy for alcoholic fatty liver:the liver was mildly or moderately enlarged,with smooth capsule and clear boundary.Ultrasonoscopy for alcoholic hepatitis:hepatic cells were edema,the liver was enlarged or normal,the capsule was not smooth,and the echo of liver parenchyma was enhanced and uneven.Ultrasonoscopy for alcoholic liver fibrosis:intrahepatic fibrous tissue hyperplasia,liver enlargement,blunt edge,liver parenchyma echo increased,thickened,and uneven.Ultrasonoscopy for alcoholic cirrhosis:hepatic lobule structure was destroyed,fibrous tissue hyperplasia,the boundary was clear,the capsule was thickened,and the echo of liver parenchyma was dense and diffused.Conclusion:Using color Doppler ultrasonography in the diagnosis of ALD can clearly show the damage of liver and is one of the effective means of imaging examination,which has certain value in assisting the differentiation of ALD,it is helpful for the clinician to diagnose the type of liver disease as soon as possible and make corresponding treatment measures,which is worthy of clinical promotion.