肝硬化门静脉高压时脾、胃-肾静脉分流的超声诊断

目的探讨肝硬化门静脉高压时自发性脾、胃-肾静脉分流的彩色多普勒超声（CDFI）表现及其在诊断中的应用价值。方法回顾性分析门静脉高压时自发性脾、胃-肾静脉分流的21例CDFI图像特征。结果（1）自发性脾、胃-肾静脉分流声像图特点是脾、胃区与左肾之间异常走行的迂曲管道,频谱多普勒示其内血流为类似门静脉样频谱,动态观察可见其与左肾静脉相通;（2）在分流支较为粗大时可有间接的声像图表现：肝侧脾静脉内为离肝血流信号;左肾静脉内径增宽、血流速度增快及频谱形态改变。结论门静脉高压时自发性脾、胃-肾静脉分流具有典型的CDFI图像,可作为超声诊断的重要依据。

Ultrasound Diagnosis of Shunt Between Spleen and Gastric-Renal Vein in Liver Cirrhosis with Portal Hypertension

Objective To approach to the characteristics and the application values of color Doppler flow imaging(CDFI)in the diagnosis of spontaneous shunt between splenic,gastric-renal vein in liver cirrhosis with portal hypertension.Methods The characteristics of CDFI in spontaneous shunt between spleen,gastric-renal vein in liver cirrhosis with portal hypertension were retrospectively analysed.Results 1.The ultrasonic characteristics of the spontaneous splenic,gastric-renal shunt was that the Doppler spectra in the abnormal tortuous circuit conduits lying between the splenic,gastric-renal area were very similar to the portal venous Doppler connected to the portal venous Doppler as dynamiclly observed.2.The indirect sonographic appearance was obtained when the shunting branch was more enlarged:the blood flow signal in the splenic vein was away from the liver near to the portal vein;the inner diameter of the left renal vein was widened;the blood flow velocity was faster,and the shape of the flow spectrum was changed.Conclusions There were typical CDFI sonograms in spontaneous shut between spleen,gastric-renal area,which may assist the diagnosis via observation.CDFI is a noninvasive method which may provide reliable clinical diagnosing evidences.