实时灰阶超声造影评价肝移植术前门脉系统栓子的价值

目的探讨实时灰阶超声造影在肝移植术前门脉系统栓子诊断及良恶性鉴别诊断中的价值。方法应用SonoVue造影剂及对比脉冲序列（CPS）技术对37例肝移植术前门脉系统栓子患者,共84条血管进行低机械指数实时灰阶超声造影检查。结果经过肝移植手术或螺旋CT门静脉成像证实,78条血管栓子形成（瘤栓50个,血栓28个）,6条血管通畅。超声造影诊断门脉系统栓子的敏感性98.7%,特异性100%,以栓子内动脉相早期造影剂灌注为标准,诊断门脉系统瘤栓的敏感性100%,特异性100%。结论实时灰阶超声造影可评价肝移植术前门脉系统的通畅性,提高栓子的检出率,并可鉴别栓子的良恶性,为肝移植手术方案的确定提供重要准确的信息。

The value of real-time gray-scale contrast-enhanced ultrasound in diagnosis of portal venous system thrombosis before liver transplantation

Objective To evaluate the value of gray-scale contrast-enhanced ultrasound (CEUS) in diagnosis and differential diagnosis of portal venous system thrombosis. Methods SonoVue-enhanced ultrasonography with contrast pulsed sequencing (CPS) imaging technique was performed on 84 vessels of 37 patients with portal vein system thrombosis before liver transplantation. Results Seventy-eight vessels with thrombosis (50 tumor thrombosis, 28 blood thrombosis) and 6 with normal lumens were confirmed by liver transplant surgery or spiral CT portography. The sensitivity and specificity in diagnosis of portal vein thrombosis with contrast-enhanced ultrasonography were 98.7% and 100%, respectively. Using early arterial enhancement of the thrombus on CEUS as a criterion, for the diagnosing protal venous thrombosis, the sensitivity and specificity were 100% and 100%, respectively. Conclusion CEUS can improve the detecting rate of portal venous system thrombosis and differentiate blood thrombosis from tumor thrombosis. It can be the guide for the clinicians to choose proper methods before liver transplantation.