彩色多普勒超声对肝移植术后11例血管并发症的诊断

目的评价彩色多普勒超声对肝移植术后血管并发症的诊断意义。方法回顾性分析和总结11例肝移植术后血管并发症的彩色多普勒超声检查资料,检测指标包括肝动脉及左右分支的峰值速度、阻力指数、加速度及加速时间,门静脉平均流速。结果5例经手术或造影证实为动脉并发症(血栓形成2例,肝动脉狭窄2例,肝动脉痉挛1例),彩色多普勒超声表现有肝动脉狭窄处的高速高阻血流并伴有湍流,而狭窄远端肝内动脉峰值速度<40cm/s,阻力指数<0.5,加速时间>0.08s,加速度<300cm/s2,2例肝动脉血栓形成肝门部无动脉血流信号;6例为门静脉并发症(3例门静脉狭窄,3例门静脉血栓形成)。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的指导意义。

Role of color Doppler ultrasonography in diagnosis of vascular complications following liver transplantation

Objective To evaluate the value of color Doppler ultrasonography (CDUS) in diagnosis of vascular complications after liver transplantation.Methods The CDUS data of 11 cases of vascular complications was retrospectively reviewed. The measured indexes included hepatic artery peak velocity (HAPV), resistance index (RI), hepatic artery acceleration (HAAC), systolic acceleration time (SAT), time-average blood flow velocity of portal vein. Results Five cases of hepatic artery complications including hepatic artery thrombosis (HAT) in 2, hepatic artery stenosis (HAS) in 2 and hepatic artery spasm in 1 patient were identified by angiography or surgery. The findings by CDUS included: HAPV less than 40 cm/s, RI less than 0.5, SAT longer than 0.08 s, HAAC less than 300 cm/ s~2. Two case showed no hepatic arterial flow around portal vein. The other 6 cases had portal vein complications including portal vein stenosis(PVS)in 3 and portal vein thrombosis(PVT) in 3 respectively.Conclusion CDUS has an important value in the diagnosis of vascular complications following liver transplantation.