超声造影对食管胃底静脉重度曲张的定量分析诊断

目的 探讨超声造影在门脉高压性食管胃底静脉重度曲张无创诊断中的应用价值.方法 13例无食管静脉曲张的正常对照者（对照组）及11例胃镜、上消化道造影及临床提示食管胃底静脉重度曲张的患者（病例组）接受超声造影检查,采集食管胃底部位动态造影数据,应用QLAB图像分析软件,获得时间-强度曲线,得到以下定量参数：开始增强时间（AT）、达峰时间（TTP）、达峰强度绝对值（DPI）及曲线上升支斜率（A）.结果 造影后病例组食管胃底管壁厚度达（0.87±0.08）cm,远大于正常组（0.38±0.03）cm（P〈0.05）.病例组开始增强时间（AT）、达峰时间（TTP）分别为（16.76±1.23）s、（32.77±0.06）s,较正常组（15.04±1.48）s、（28.99±1.87）s明显延长（P〈0.05）.病例组的达峰强度绝对值（DPI）、曲线上升支斜率（A）增大,但差异无统计学意义（P〉0.05）.结论 超声造影对食管胃底静脉重度曲张的诊断有独特的优势,有望成为其无创诊断的新方法.

Quantitative analysis and diagnosis of contrast-enhanced ultrasond in the application of severe esophageal gastric varices

Objective To evaluate the applications of contrast-enhanced ultrasound in the diagnosis of esophageal gastric varices in patients with portal hypertension by tension. Methods The control group consisted of thirteen patients without esophageal varices.Eleven patients with severe esophageal and gastric varices diagnosed by endoscopy, upper gastrointestinal imaging and clinical were enrolled as case group. All patients underwent contrast-enhanced ultrasound, and the dynamic angiography data of esophageal and gastric varices were collected. Time-intensity curves were drawn by QLAB analyzing software. The quantitative parameters for arrival time （AT）, time to peak （TIP）, derived peak intensity （DPI）, slope rate of ascending curve （A） were compared. Results The thickness of esophageal gastric tube wall was （0.87±0.08）mm in the case group,which was significantly different from the thickness of the control group （P〈0.05）.In the control group, AT was （15.04±1.48）s, TIP was （28.99±l.87）s.In the case group,AT was（16.76±l.23）s,TFP was （32.77±0.06）s,which was significantly different from those of the control group （P〈0.05 ）.Changes of derived peak intensity （DPI） and slope rate of ascending curve （A）were no statistically significant （P〉0.05）. Conclusion Contrast-enhanced ultrasound has a unique advantage in the diagnosis of severe esophageal gastric varices, which is expected to become a new method of noninvasive for severe esophageal gastric varices.