肝移植术后脾动脉窃血综合征的超声诊断

目的  探讨超声诊断肝移植术后脾动脉窃血综合征(SASS)的价值。方法  通过对肝移植术后10例并发SASS患者(研究组)及术后肝功能恢复正常的8例患者(对照组)进行常规超声及超声造影检查, 总结SASS的超声表现。将研究组患者的数字减影血管造影术(DSA)检查结果与超声造影进行对比。结果  研究组二维超声见肝脏回声正常或肝内见多发细小坏死灶, 彩色多普勒血流显像(CDFI)可见肝动脉内血流信号稀少或呈星点状, 超声造影见移植肝肝动脉内造影剂增强信号微弱。肝动脉内径偏细, 脾动脉内径明显增粗。超声造影与DSA的诊断结果一致。结论  常规超声及超声造影应常规作为肝移植术后的可疑移植肝血管系统异常的无创检查手段, 具有较高的应用价值。

Ultrasonographic diagnosis of splenic artery steal syndrome after liver transplantation

Objective To evaluate the value of ultrasonography in the diagnosis of splenic artery steal syndrome(SASS) after liver transplantation. Methods Routine ultrasonography and contrast enhanced ultrasound(CEUS) were performed in 10 cases with SASS(SASS group) and 8 cases of control patients with normal liver function after liver transplantation. The ultrasonographic findings of SASS were summed up. The diagnostic efficacy of CEUS was compared with that of digital subtraction angiography(DSA). Results In the SASS group, 2D ultrasonography showed that the hepatic parenchyma was normal or there were some tiny necrosis foci in it, and color Doppler flow imaging (CDFI) showed that the blood flow signal of the hepatic artery was sparse or punctiform. CEUS showed the delayed and weak contrast-enhanced signals in hepatic artery after transplantation. The internal diameter of the splenic artery increased while that of the hepatic artery decreased. There was no significant difference between CEUS and DSA. Conclusions The routine ultrasonography and CEUS have a high value on the detection of suspected abnormal vascular system of transplant liver after liver transplantation as the noninvasive diagnostic tools.