门脉海绵样变的彩色多普勒超声诊断

目的：研究彩色多普勒在门脉海绵样变诊断中的应用,提高诊断的正确性。方法：对35例门静脉海绵燕变进行了彩色多普勒检查,先用两维图像显示肝门部结构、门脉主干及分支,以及周围侧枝血管回声,再用彩色多普勒显示血流方向、颜色。结果：根据形态学及超声表现可将门脉海绵样变分为三型：I型为肝外型;Ⅱ型为肝内型;Ⅲ型为肝内肝外型。门脉海绵样变的二维超声主要表现为：肝内外门静脉分支及主干狭窄或部分狭窄、闭塞,在其周围形成蜂窝状无回声区,门脉管壁回声增强,增厚,彩色多普勒超声显示血流呈红蓝相间,频谱多普勒显示门静脉血流呈毛刺状,为低速、平坦的血流流速曲线。结论：彩色多普勒血流显像对门脉海绵样变的诊断具有很高的准确性,是诊断门脉海绵样变的重要手段。

Color Doppler Ultrasound in the Diagnosis of Cavernous Transformation of the Portal Vein

Objective: To improve diagnostic accuracy of cavernous transformation of the portal vein (CTPV) with color Doppler ultrasound (CDUS). Methods: In 35 patients with CTPV, the structure of porta hepatis, the lumen and collateral vessels of portal vein were examined by B-Mode ultrasound and CDUS. At the same time the echo of liver parenchyma,the size of spleen were observed. The color Doppler showed the direction and velocity of blood flow. Results: The patients with CTPV could be divided into three type based on morphologic and ultrasonic appearance . The main characteristic of CTPV on imaging was absence of blood flow or thrombus of the normal portal vein lumen and branches. The collateral and sponge - like vessel of PV were showed on CDUS. The Doppler spectrum of CTPV was "flat" and slower velocity waveform. Conclusion: CDUS may be a reliable and useful method for diagnosing CTPV.