超声检查在肝移植术后胆道狭窄中的应用价值

The Application Value of Ultrasound Examination in Biliary Stricture after Liver Transplantation

目的:探讨肝移植术后胆道狭窄采用超声检查的应用价值。方法:回顾分析2020年1月-2023年3月,在我院行肝移植术的157例患者,其中20例患者术后发生胆道狭窄,选取38例无并发症的患者列为对照组,对比两组间肝右动脉峰值流速、肝右动脉阻力指数、肝右动脉加速时间及胆道超声声像,并分析超声诊断肝移植后胆道狭窄的敏感度、特异度。结果:胆道狭窄组患者术后肝右动脉阻力指数明显低于对照组(P<0.05);胆道狭窄组患者与对照组的肝右动脉峰值流速及加速时间比较(P>0.05);胆道狭窄患者超声检查结果各项发生率均高于无并发症组(P<0.05);以肝内胆管扩张、胆管壁回声增强、胆总管管壁增厚、超声造影显示胆管壁灌注欠佳为诊断标准,超声检查诊断肝移植术后胆道狭窄的敏感度为60.0%,特异度为79.0%。结论:肝移植术后胆道狭窄患者采用超声检查进行诊断,能够为诊治提供可靠数据。

Objective:To explore the application value of ultrasound examination for biliary stenosis after liver transplantation.Methods:A retrospective analysis was conducted on 157 patients who under-went liver transplantation in our hospital from January 2020 to March 2023.Among them,20 patients de-veloped postoperative biliary stenosis,and 38 patients without complications were selected as the control group.The peak flow velocity of the right hepatic artery,resistance index of the right hepatic artery,accel-eration time of the right hepatic artery,and biliary ultrasound images were compared between the two groups,and the sensitivity and specificity of ultrasound in diagnosing biliary stenosis after liver transplan-tation were analyzed.Results:The postoperative right hepatic artery resistance index of patients with bili-ary stenosis was significantly lower than that of the control group(P<0.05).There were no significant dif-ferences in the peak flow velocity and acceleration time of the right hepatic artery between patients with biliary stenosis and the control group(P>0.05).The incidence of various abnormalities detected by ultra-sound was significantly higher in patients with biliary stenosis compared to the non-complication group(P<0.05).The diagnostic criteria for intrahepatic bile duct dilation,enhanced echogenicity of the bile duct wall,thickening of the common bile duct wall,and poor perfusion of the bile duct wall on contrast-enhanced ultrasound were used.The sensitivity and specificity of ultrasound in diagnosing biliary stric-ture after liver transplantation were 60.0%and 79.0%,respectively.Conclusion:Ultrasound examination can provide reliable data included the diagnosis and treatment of biliary strictures in patients after liver transplantation.