超声检查对门脉栓子良恶性的鉴别诊断

目的：探讨超声检查对门脉栓子良恶性的鉴别诊断.方法：2008年5月至2009年10月来本院就诊的门脉栓子形成患者18例,其中血栓10例,癌栓8例.应用二维,彩色多普勒及超声造影方法对栓子的良恶性进行鉴别,并与病理结果相对比分析并追踪随访.结果：10例血栓二维超声门脉管腔清晰,栓子边界清楚.彩色多普勒显示栓子内未见血流信号.超声造影示动脉相、门脉相及延迟相均未见增强信号.8例癌栓二维超声门脉管腔显示模糊,呈均匀或不均匀低回声,栓子边界欠清晰.彩色多普勒显示部分栓子内见动脉样血流频谱.超声造影示动脉相7例高增强,1例动脉相部分高增强,门脉相及延迟相8例均快速消退呈低增强.3例动脉相肝脏可见弥漫的高增强区,门脉相快速消退为低增强.结论：二维及彩色多普勒造声对于门脉栓子的良恶性鉴别有一定局限性,超声造影对门脉栓子的良恶性鉴别有重要的价值.

Role of ultrasonography in the differential diagnosis of portal thrombosis

Objective： To evaluate the role of uhrasonography in the differential diagnosis of portal thrombosis. Methods： 18 patients with portal thrombosis were examined with uhrasonography, 10 cases of benign thrombosis were detected, 8 cases of malignant thrombosis were detected, the results of uhrasonography were compared with pathological examination. Enhancement process were assessed. Results ： All 10 cases of benign thrombosis were not enhanced ,all 8 cases of malignant thrombosis were variously enhanced： In 8 patients with malignant thrombosis showed homogeneous or unhomogeneous echo and fuzzy edge, hypereehoic enhance was found in 7 patients with malignant thrombosis. Conclusion： Uhrasonography is important in the differential diagnosis of portal vein thrombosis but to some extent.