普通彩色多普勒血流显像技术在小儿肝移植术后早期肝动脉栓塞中的诊断价值

目的评价普通彩色多普勒血流显像(CDFI)技术在小儿肝移植术后早期肝动脉栓塞(HAT)中的诊断价值。方法回顾性分析2005年4月至2014年5月在武警总医院施行的55例小儿肝移植病例的临床资料。对所有病例在术后早期应用CDFI技术进行常规血流监测。经CDFI多切面检查于肝内未见肝动脉血流信号拟诊HAT,对怀疑HAT者进行计算机体层摄影术血管造影(CTA)检查或手术探查。应用Chiss统计软件,计算普通CDFI技术诊断HAT的灵敏度和特异度。结果 55例小儿肝移植受者中,CDFI检查共拟诊3例HAT,其中2例为肝动脉主干栓塞,1例为肝右动脉栓塞,均经CTA检查和手术探查证实诊断。本组病例HAT发生率为5%(3/55)。应用普通CDFI技术诊断小儿肝移植术后HAT的灵敏度为1.0、特异度为1.0、假阳性率为0。结论普通CDFI技术为小儿肝移植术后血流动力学检测首选的、最主要的检查手段,经验丰富的移植超声医师实施检查可提高诊断HAT的准确性。

Value of ordinary color Doppler flow imaging in the diagnosis of hepatic artery thrombosis in early stage after pediatric liver transplantation

Objective To study the value of ordinary color Doppler flow imaging（ CDFI） in the diagnosis of hepatic artery thrombosis（ HAT） in early stage after pediatric liver transplantation（ PLT）.Methods Clinical data of 55 children undergoing PLT in the General Hospital of Chinese People＇s Armed Police Forces from April 2005 to May 2014 were analyzed retrospectively. Conventional hemodynamic monitoring was performed in all cases in the early stage after operation by CDFI. No intrahepatic arterial blood flow signal was observed by CDFI multi-angle examination and HAT was suspected. Computed tomography angiography（ CTA） and surgical exploration were performed in the suspected HAT patients. The sensitivity and specificity of ordinary CDFI in diagnosing HAT were calculated by Chiss statistical software. Results Among the 55 PLT recipients,3 cases were suspected as HAT by CDFI,including 2 cases of HAT in the main hepatic artery,1 cases of HAT in the right hepatic artery. All cases were confirmed by CTA or surgical exploration.The incidence of HAT was 5%（ 3 /55）. The sensitivity and the specificity of CDFI in diagnosing HAT after PLT were both 1. 0,and false positive rate was 0. Conclusions Ordinary CDFI is the preferred and main method for hemodynamic examination after PLT. The experienced sonographer for transplantation can improve the accuracy in diagnosing HAT.