超声造影在肝移植术后血管源性并发症中的应用

目的探讨超声造影在检测肝移植术后血管源性并发症中的应用价值。方法对肝移植术后经彩色多普勒血流显像检查疑肝血管血流异常患者行超声造影检查，观察肝动脉、门静脉、下腔静脉及肝实质的血流灌注，对其中29例经数字减影血管造影（DSA）或CT血管造影（CTA）／MR血管造影（MRA）证实的病例进行分析。结果术后血管源性并发症患者28例，其中肝动脉狭窄22例，肝动脉血栓闭塞3例（肝动脉血栓闭塞合并肝梗死2例），门静脉狭窄2例，下腔静脉狭窄1例，另1例为肝门部血肿并肝动脉、门静脉受压狭窄。超声造影可明确诊断肝动脉血栓闭塞，显示肝动脉、门静脉及下腔静脉狭窄，与DSA或CTA／MRA结果符合率分别为100％（3／3）、90．9％（20／22）、100％（2／2）及100％（1／1）。结论超声造影对肝移植术后血管源性并发症的诊断具有较高的准确率，对指导临床诊断及治疗具有重要的临床应用价值。

Application of contrast-enhanced ultrasound in detecting vascular complications after liver transplantation

Objective To evaluate the value of contrast-enhanced ultrasound （CEUS） in detecting vascular complications after liver transplantation. Methods The liver transplantation recipients suspected by CDFI with vascular complications underwent CEUS to observe hepatic artery, portal vein, inferior vena cava and perfusion of liver parenchyma. Twenty-nine patients who were confirmed by CT angiography （CTA） or digital subtraction angiography （DSA） or magnetic resonance angiography （MRA） were analyzed. Results There were 28 patients with vascular complications, including 22 with hepatic artery stenosis （HAS） ,3 with hepatic artery thrombosis （HAT） ,2 with portal vein stenosis （PVS） and I with inferior vena cava stenosis （IVCS）. CEUS could confirmed not only HAT, but also diagnosed HAS, PVS and IVCS. The accordance rates for HAT, HAS, PVS and IVCS detected by CEUS compared to DSA and/or CTA and/or MRA were 100% （ 3/3 ）, 90.9% （ 20/22 ）, 100% （ 2/2 ） and 100% （ 1/1 ）. Conclusions CEUS may improve the diagnostic accuracy of vascular complications after liver transplantation.