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1.
目的评价彩色多普勒超声对原位肝移植患者术后肝动脉血栓形成的诊断价值.方法分析和总结6例原位肝移植后肝动脉血栓形成患者的彩色多普勒超声检查资料,6例患者均经手术或造影证实.结果 5例肝门和肝内门静脉周围均没见肝动脉血流信号,其中1例膈下动脉分支伸入肝内形成侧支循环, 另1例术后第3天肝动脉血流信号显示,术后第5天未见肝动脉血流; 6例均见门静脉流速增高;3例肝内见坏死灶;2例肝内胆管轻度扩张;2例Glisson鞘回声增强.结论彩色多普勒超声对肝移植后肝动脉血栓形成的诊断有重要作用. 相似文献
2.
肝移植术后彩色多普勒血流动力学研究 总被引:1,自引:0,他引:1
目的 探讨肝移植术后肝内血流动力学变化.方法 156例肝移植患者,应用灰阶超声观察移植肝形态、实质回声,彩色多普勒超声观察移植肝动静脉及吻合口血流通畅情况,测量血流动力学参数.结果 肝移植患者术后早期肝实质回声增强.肝移植术后门静脉峰值流速术后第1 d最高,以后渐降低;肝动脉峰值流速在随访期无明显变化;肝动脉阻力指数测值术后第1 d最高,以后则下降(P<0.05).结论 彩色多普勒超声可用于评价肝移植后血流动力学变化. 相似文献
3.
Successful conservative therapy for portal vein thrombosis after living donor liver transplantation 总被引:1,自引:0,他引:1
Portal vein thrombosis remains a significant cause of graft loss in liver transplantation. A case with thrombosis at the anastomotic
site is described. Close follow-up with ultrasound enabled us to treat the patient promptly and successfully with anticoagulants.
Received: 3 August 2001/Accepted: 22 August 2001 相似文献
4.
Background: To determine whether a difference exists in the relative ability of power Doppler sonography and conventional color Doppler
sonography to detect the intratumoral vasculature of hepatocellular carcinoma based on lesion size and location.
Methods: Sixty patients with 88 hepatocellular carcinoma lesions that showed tumor staining on angiography and were enhanced on dynamic
computed tomography were evaluated. Power Doppler sonography and color Doppler sonography were used to detect the intratumoral
vasculature, and their sensitivity to blood flow was evaluated.
Results: Power Doppler sonography showed a superior detection rate for lesions smaller than 2 cm and located 4–8 cm from the abdominal
surface in the right hepatic lobe as compared with color Doppler sonography (p < 0.01). Neither power Doppler sonography nor color Doppler sonography depicted the intratumoral vasculature of lesions located more
than 8 cm from the abdominal surface (n = 14). Both color Doppler imagings exhibited a low detection rate for lesions in the left hepatic lobe (n = 31, p < 0.01).
Conclusions: Power Doppler sonography should be applied in the evaluation of small or intermediate depth lesions because it is more sensitive
to these lesions than color Doppler sonography, but it is not useful for left lobe and deep lesions.
Received: 31 March 1999/Accepted: 14 July 1999 相似文献
5.
Background: To determine whether abnormal hepatic vein Doppler tracings can be used to predict liver transplantation rejection.
Methods: A total of 158 hepatic vein Doppler tracings were obtained on 93 postliver transplant patients (63 patients without rejection
and 30 patients with biopsy-proven rejection). Hepatic vein Doppler tracings were scored according to an established grading
system (0 = normal triphasic waveform, 1 = dampened waveform, with loss of flow reversal, 2 = completely flat waveform). The
hepatic vein Doppler tracings were then correlated with biopsy findings.
Results: In the group of 63 patients without rejection, 124 Doppler examinations were performed and graded as follows: 0 = 87 (70%),
1 = 31 (25%), and 2 = 6 (5%). In the group of 30 patients with biopsy-proven rejection, 34 Doppler examinations were performed
and graded as follows: 0 = 16 (47%), 1 = 14 (41%), and 2 = 4 (12%). The sensitivity of abnormal hepatic vein Doppler tracings
for detection of rejection was 53% and the specificity was 70%. The positive predictive value of an abnormal hepatic vein
Doppler tracing was 33% and the negative predictive value of a normal Doppler tracing was 84%.
Conclusions: Abnormal hepatic vein Doppler tracings are observed in patients with and without liver transplant rejection. Abnormal tracings
cannot be used to predict liver transplant rejection.
Received: 7 January 1997/Revision accepted: 17 April 1997 相似文献
6.
H. Ishida K. Konno Y. Hamashima H. Naganuma T. Komatsuda M. Sato S. Kato J. Ishida O. Masamune 《Abdominal imaging》1998,23(6):587-591
We present six cases of ruptured liver tumor (hepatocellular carcinoma, five cases; liver metastasis, one case) in which
gray-scale sonography revealed an ascites containing constantly moving dense high-echo spots, leading to a high suspicion
of acutely developing hemoperitoneum. Color Doppler sonography helped in detecting the rupture site by demonstrating a high-velocity
jet flow from it. Although four of six patients were dead within 3 months, detection of the rupture site by color Doppler
sonography made the initial transarterial embolization therapy easy and prompt.
Received: 17 June 1997/Accepted: 6 August 1997 相似文献
7.
Liver involvement with hereditary hemorrhagic telangiectasia (HHT) is not a rare condition. Its angiographic abnormalities
are well known, but reports of the sonographic and, especially, color Doppler sonographic findings are limited. We present
a patient with HHT and describe the hepatic color Doppler sonographic findings.
Received: 0/0/00/Accepted: 0/0/00 相似文献
8.
目的应用彩色多普勒超声(CDI)检查原位肝移植(OLT)术后移植肝形态学及血流动力学改变,并探讨彩色多普勒超声对急性排斥反应的意义.方法 16例原位肝移植,于术后测量HA-V、HA-RI、ACC、AT、PV-V及描述肝静脉波形等血流动力学参数,其中11例在1个月内行细针穿刺组织学活检.结果 1例出现急性排斥反应,其肝静脉波形呈典型的急性排斥反应特征.结论彩色多普勒超声能很好地提示肝移植术后急性排斥反应的出现和转归. 相似文献
9.
K. Konno H. Ishida M. Sato H. Naganuma K. Obara H. Andoh S. Watanabe 《Abdominal imaging》2002,27(1):47-50
Gallbladder (GB) perforation is a life-threatening complication of acute cholecystitis, and early diagnosis prevents delay
in patient management. We present two cases of GB perforation diagnosed by color Doppler ultrasonography. Each clearly showed
a flow signal passing through the perforated site, leading to prompt and successful surgical treatment. This interesting observation
suggests that color Doppler ultrasonography is useful in the diagnosis of GB perforation.
Received: 20 February 2001/Accepted: 21 March 2001 相似文献
10.
彩色多普勒超声评价肝移植术后肝动脉血流动力学改变及其临床意义 总被引:2,自引:0,他引:2
目的 探讨肝移植术后肝动脉血流动力学改变及其临床意义。方法 回顾性分析术后接受了系列多普勒超声检查的42例肝移植患者,依肝右动脉阻力指数(RI)不同分为低阻力型(RI<0.5)、阻力正常型(0.5≤RI<0.8)、高阻力型(RI≥0.8)。分析术后肝右动脉收缩期峰值流速(PSV)和RI的变化及其与患者术后2月内病情转归的关系。结果 肝移植术后第1~3d肝右动脉RI测值中,64.3%为阻力正常型,26.2%为高阻力型,9.5%为低阻力型。肝右动脉PSV术后早期测值偏低,之后逐渐上升。RI值于术后早期测值偏高,之后逐渐减低。肝移植术后2月内死亡或危重的患者共9例,其中6例(66.7%)术后第1~3d肝右动脉PSV%30cm/s和(或)RI<0.5。结论 肝移植术后早期肝动脉RI增高是一种常见的表现,与临床表现无关;术后早期肝右动脉PSV<30cm/s和(或)RI〈0.5会导致术后早期高死亡率。 相似文献
11.
Hepatic artery thrombosis remains a significant cause of graft loss in liver transplantation. We describe a case with thrombosis
of the middle hepatic artery that revascularized spontaneously. Close follow-up with duplex ultrasound enabled us to treat
the patient promptly and successfully with anticoagulants and antibiotics.
Received: 2 May 2001/Accepted: 16 May 2001 相似文献
12.
We describe a case of living donor liver transplantation where an intrahepatic portal vein embolism was detected by intraoperative
ultrasonography after the completion of portal and arterial anastomoses. The recipient portal vein trunk was clamped and the
ligature of the graft's right portal branch was released, thus maintaining the sole arterial supply. Backward flushing of
the portal system was achieved, which removed the clot through the reopened right portal branch without the need for thrombectomy
by Fogarty balloon catheter. 相似文献
13.
14.
目的 探讨彩色多普勒超声检测肝移植术后肝静脉血流动力学变化,早期诊断术后肝静脉及下腔静脉并发症和评价肝功能的临床价值。方法 67例原位肝移植术后患者行彩色多普勒超声检查,观察肝移植患者肝实质、血管、胆管声像图改变和肝静脉血流动力学变化时。对54例无肝静脉及下腔静脉并发症患者,记录血浆凝血酶原时间(PT)、血清总胆红素(Tbil)、白蛋等相关指标,观察有无腹水、肝性脑病,按Child—Pugh评分分级,并且与肝静脉血流改变对照。结果 67例原位肝移植术后,下腔静脉栓塞5例,肿瘤复发伴下腔静脉、肝静脉狭窄8例。54例无肝静脉及下腔静脉并发症患者肝静脉血流改变随着肝功能Child—Pugh分级变化改变明显,具有统计学意义(P〈0.005)。结论 彩色多普勒超声检测对肝移植术后肝静脉、下腔静脉并发症诊断和肝功能评价有重要临床意义。 相似文献
15.
目的 总结目前常用人工肝治疗方法:血浆置换(Plasma exchange)、血液灌流(Hemoperfusion)和分子吸附再循环系统(Molecular adsorbent recirculatint system)联合肝移植治疗慢性肝功能衰竭的经验。方法 对7例慢性肝脏功能衰竭患者分别应用上述三种人工肝方法治疗15人次,于治疗前后分别检测肝功能、凝血酶原活动度、血氨等指标,并观察临床症状、体征变化。人工肝支持治疗后接受原位肝移植治疗。结果 人工肝治疗后多数患者的乏力、纳差、腹胀等症状明显缓解,7例均顺利进行原位肝脏移植,其中6例成活。结论 人工肝可明显改善慢性肝功能衰竭患者术前状况,为肝移植赢得时间和创造条件。 相似文献
16.
彩色多普勒超声检查在诊断原位肝移植术后胆道并发症中的作用——与胆道造影术对比性研究60例分析 总被引:2,自引:0,他引:2
目的:探讨彩色多普勒超声检查(彩超)在肝移植术后胆道并发症诊断中的作用。方法:分析行肝移植的312例患者发生胆道并发症的情况,以胆道造影术为金标准评价彩超在诊断这些患者胆道并发症诊断中的作用。结果:共60例患者行胆道造影术明确胆道并发症的诊断,在胆道造影检查前2周内所行的胆道彩超结果示,彩超诊断胆道梗阻、胆漏、胆泥、胆结石敏感度分别为82%、80%、40%、100%;特异度分别为100%、100%、84%、96%。结论:彩超在诊断胆道并发症中敏感度、特异度较高,对诊断胆道并发症具有一定的意义。 相似文献
17.
目的评价超声造影对原位肝移植术后患者移植肝动脉血栓形成(HAT)的诊断价值。方法6例原位肝移植术后患者,彩色多普勒超声诊断为移植肝动脉血栓形成和肝动脉血流异常,再行超声造影检查。结果3例患者经超声造影证实为HAT,并经手术证实,其余3例超声造影后清晰显示肝动脉。结论超声造影对原位肝移植术后HAT具有重要的诊断价值。 相似文献
18.
彩色多普勒超声诊断原位肝移植术后血管并发症 总被引:6,自引:0,他引:6
目的评价彩色多普勒血流成像(CDFI)对原位肝移植术(OLT)后血管并发症的诊断价值.方法回顾性分析55例原位肝移植患者的CDFI检查资料.结果55例OLT术后患者中,CDFI发现血管并发症患者7例(13%):2例肝动脉血栓形成患者肝门部肝动脉和肝内左右分支均未见彩色血流信号,1例门静脉右后叶支血栓形成,门静脉吻合口狭窄2例,门静脉肝动脉动静脉漏1例,肝静脉血栓形成1例,4例经手术或血管造影证实(4/7,57%).结论彩色多普勒超声对肝移植术后血管并发症的诊断具有重要价值. 相似文献
19.
肝肺综合征患者肝移植术中体、肺循环血流动力学变化 总被引:2,自引:0,他引:2
目的:分析终末期肝病肝肺综合征(HPS)患者肝移植术中体、肺循环血流动力学的变化。方法:26例HPS患者为HPS组;20例无低氧血症、无原发心肺疾病的原位肝移植术患者为对照组。两组病例均接受改良背驼式原位肝移植术,观察术中体、肺循环血流动力学的变化及术后转归。结果:(1)与对照组相比,HPS组术前心排量(CO)较高,平均肺动脉压(MPAP)、肺动脉楔压(PAWP)、体循环阻力(SVR)及肺循环阻力(PVR)均较低;术中SVR、PVR均较低,而PAWP在新肝期较低。(2)与术前相比,HPS组CO在新肝15min时较低,新肝30min后无差异;对照组在新肝15min时差异无显著性,新肝30min后上升。(3)与术前相比,HPS组PVR在新肝30min后差异无显著性,SVR下降;对照组在新肝30min后PVR、SVR均下降。(4)HPS组患者围术期死亡6例,死亡率为23.1%,对照组全部存活。结论:HPS患者肝移植围术期表现为高心排量、低体及肺循环阻力的状态,其围术期死亡率高。 相似文献
20.
A. Uno H. Ishida K. Konno Y. Ohnami H. Naganuma M. Niizawa Y. Hamashima O. Masamune 《Abdominal imaging》1997,22(1):72-78
Portal hypertension is a relatively uncommon pathologic condition in children and young adults in contrast with older adults.
The aim of this study is to evaluate the utility of sonography and color Doppler sonography in the diagnosis of portal hypertension
in children and young patients and to evaluate the sonographic pattern of each disease. We reviewed 25 such patients who were
younger than 30 years old and obtained the following sonographic findings: (1) liver cirrhosis: (a) multiple intrahepatic
venovenous shunts in patients with primary Budd-Chiari syndrome and (b) intrahepatic vascular narrowing and nodular coarse
parenchymal texture, with multiple very-high-echo spots along the portal vein in patients with Wilson disease; (2) congenital
hepatic fibrosis: marked and developed collaterals, wide periportal echogenic band, and a heterogeneous parenchymal texture
comprised of multiple high echoes but without portal thrombus; and (3) extrahepatic portal thrombosis: invisible portal lumen
except as an echogenic band. Sonography and color Doppler sonography are very useful in diagnosing these portal hypertensive
diseases. However, there are no specific sonographic findings, and the role of sonography is limited to follow-up observation
of associated secondary hepatobiliary changes in patients with congenital biliary atresia.
Received: 1 May 1995/Accepted: 24 June 1995 相似文献