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目的探讨超声诊断肝小静脉闭塞病(HVOD)的可行性。方法对仅以超声前瞻性提示HVOD后经肝脏穿刺活检病理证实及临床支持性诊断的22例HVOD患者回顾性分析其超声影像学特点,并设肝炎后肝硬化对照组,分析两样本间参数差异,探讨HVOD超声诊断参数。结果(1)22例HVOD患者均为彩超首先发现。HVOD组与对照组比较肝内“荒芜征”、门静脉反流信号、肝静脉造影剂开始显示时间(TV)及造影剂肝脏通过时间(TA-V)有显著差异(P<0.001)。(2)超声引导下选择性肝脏组织穿刺活检病理诊断是金标准。结论超声诊断尤其是低声压超声造影对HVOD微循环病变的判断有一定价值。
Objective To investigate the feasibility of using ultrasonography to diagnose hepatic veno-occlusive disease (HVOD). Methods Twenty-two patients with HVOD diagnosed by pathologic examination of liver biopsy and clinical supportive diagnosis by ultrasound-prospective HVOD retrospectively analyzed the characteristics of ultrasound imaging and post-hepatitis cirrhosis control group, and analyzed the difference of the parameters between the two samples , Discuss HVOD ultrasonic diagnostic parameters. Results (1) 22 cases of HVOD were detected by color Doppler ultrasound. There were significant differences (P <0.001) between HVOD group and control group in intrahepatic “barren sign”, portal vein reflux signal, start time of hepatic venous contrast agent (TV) and contrast agent liver transit time (TA-V) (2) Ultrasound-guided selective liver biopsy biopsy pathological diagnosis is the gold standard. Conclusion Ultrasound diagnosis, especially low-contrast ultrasonography, has certain value in the judgment of HVOD microcirculation.