摘要
本文旨在探讨彩色多普勒超声诊断内支架狭窄及闭塞的应用价值。３４例肝硬化门脉高压患者行ＴＩＰＳＳ术，术前均行彩超检查，术后定期复查，首次复查在术后１～７天内进行。术前门脉血流均为“进肝流向”，门脉主干血流速度为１７．２±４．７ｃｍ／ｓ；术后门脉主干血流速度为５１．３±１４．７ｃｍ／ｓ。门脉左、右分支血流，１０例转为“离肝流向”，４例呈双向血流，３例左支及矢状部无彩色血流信号。内支架内血流速度在７１．６～２３６ｃｍ／ｓ，平均１３６±４８．４ｃｍ／ｓ。经２５天～３年的随访，９例内支架血流速度大幅降低，门脉主干血流速度亦显著降低，提示内支架狭窄存在；４例支架内无多普勒血流信号，提示内支架已闭塞；后经血管造影证实。其门脉左右分支血流方向均呈“进肝流向”。结果表明，彩色多普勒超声是检测内支架血流状况的简便有效方法。术前及术后即刻检测的门脉及内支架血流变化的结果，可作为随访评价支架血流状况的标准。
The utility of color Doppler sonography (CDS) in the diagnosis of the stenosis or occlusion of stents was investigated. TIPSS were performed in 34 cases, of liver cirrhosis with portal hypertension. CDS exammations were done before and after TIPSS in all cases follow-up examinations were underwent at regular intervals, the first one was done in 1￣7 days after the operation. Before TIPSS, the direction of flow in portal veins was 'hepatopetal', the flow velocities in main portal veins were 17.2±4.7 cm/s. After operation the velocities in main portal veins increased to 51.3±14.7 cm/s and the flow direction in the left and right portal branches changed to 'hepatofugal'in 10 cases, bidirectional flow was found in 4 cases and no color Doppler signals in the left branches in 3 cases. The flow velocities in stents were 71.6￣236 cm/s (mean 136±48.4 cm/s). In the following-up period 25 days ￣ 3 years, the flow velocities in stents and main portal veins were significantly decreased in 9 cases, suggesting the stents were stenosed. No Doppler signals were detected in the stents of 4 cases, indicating the stents were occlused. All of which were comfirmed by angiography. The flow direction in left and right branches were 'hepatopetal'. The result suggested that CDS may be a simple and useful method to follow the patency of the stent. A thorough CDS survey of blood flow in portal vein and stent before and immediately after TIPSS may provides a baseline for the evaluation of shunt function. Its change holps to determine the presence of stent stenosis or occlusion accurately.
出处
《中华超声影像学杂志》
CSCD
1998年第2期76-80,共5页
Chinese Journal of Ultrasonography
