彩色多普勒超声评价支架植入术治疗移植肝血管狭窄

目的探讨彩色多普勒血流显像技术（CDFI）在移植肝血管狭窄支架植入术疗效评估中的价值。方法13例肝动脉狭窄,1例门静脉狭窄,2例肝静脉狭窄。于支架植入术前、后行CDFI检查并每隔3～4个月随访复查,取多普勒参数肝内动脉血流阻力指数和加速度、门静脉吻合口管径及其两端血流速度比值、肝静脉狭窄处管径及肝静脉和下腔静脉肝下段血流频谱进行统计学分析。结果肝动脉狭窄者支架植入术后RI升高,SAT缩短,治疗前后差异有显著性意义（P〈0.05）。门静脉和肝静脉狭窄者支架植入术后狭窄段管径增宽,植入的支架呈并行相间的线样强回声,门静脉吻合口两端血流速度梯度下降,肝静脉和下腔静脉肝下段血流频谱由术前的平坦波恢复为两相或三相波。结论CDFI检查是评价移植肝血管狭窄支架植入术疗效的可靠方法。

CDFI evaluation for therapeutic effect of stent implantation in transplant liver vascular stenosis

Objective To investigate the value of color Doppler flow imaging (CDFI) technique in the assessment of therapeutic effect of stent implantation for transplant liver vascular stenosis. Methods A total of 16 patients with transplant liver vascular stenosis, including 13 transplant liver artery stenosis, 1 transplant liver portal vein stenosis and 2 transplant liver hepatic vein stenosis, underwent CDFI examination before and after intravascular stent implantation. The resistive index (RI) and systolic acceleration time (SAT) of artery in transplant liver, the diameter of stenosis of portal vein and hepatic vein, the velocity ratio between proximal and distal portal vein stenosis, the Doppler wave of hepatic vein and infer hepatic vena cava were observed and analyzed statistically. Results The RI increased and SAT prolonged after stent implantation in transplant liver artery stenosis patients (P<0.05). The diameter of transplant liver portal vein and hepatic vein enlarged, and parallel intermittent string-like echoes were observed after stent implantation in the transplant liver portal vein and hepatic vein. The velocity ratio between proximal and distal portal vein stenosis decreased, while the triphasic or biphasic Doppler wave of hepatic vein and infer hepatic vena cava restored. Conclusion CDFI technique is one of the ideal and reliable methods for assessment of therapeutic effect of stent implantation for transplant liver vascular stenosis.