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目的评价彩色多普勒超声对肝前性门静脉高压的诊断价值。方法回顾2012年6月-2015年1月9例确诊为肝前性门静脉高压患者的彩色多普勒超声表现,观察受累血管内径、形态、血流性质及方向,分析瘘口及受累血管血流频谱。结果 9例患者彩色多普勒超声发现3例区域性门静脉增宽,血流增多,流速增快并出现低阻状动脉频谱,脾静脉增宽,回流受阻,脾静脉管腔内出现絮状、不规则状或条索状低弱回声,其间脾静脉管腔内血流信号减少、变细或不均、血流靠边,频谱所示局部血流紊乱,流速快慢不等;2例其他影像学方法及超声确诊脾静脉内血栓形成,其内血流信号明显减少;另4例超声未发现门脉系明显异常,经其他方法检查后得以确诊。彩色多普勒超声检查对肝前性门静脉高压的阳性诊断率为5/9,漏诊率为4/9。结论彩色多普勒超声对筛查、诊断及随访肝前性门静脉高压有一定价值,但受诸多因素影响,漏诊率较高。仔细观察门脉系统管腔结构和内部回声,血流变化,并结合其他影像学检查和重视临床病史,可进一步提高其发现率和准确诊断率。
Objective To evaluate the diagnostic value of color Doppler ultrasound in prehypertensive portal hypertension. Methods The color Doppler echocardiography was performed in 9 patients with prehypertrophic portal hypertension diagnosed from June 2012 to January 2015. The diameter, shape and flow characteristics of the involved vessels were observed. The fistulas and blood vessels involved were analyzed Spectrum. Results In 9 patients, 3 cases of regional portal vein widened, blood flow increased, flow velocity increased, and the spectrum of low resistance arteries appeared. The splenic vein widened, the backflow was blocked, and the flocculent, Irregular shape or cord-like low echo, during which the splenic vein lumen flow signal reduction, thinning or uneven, blood flow aside, the spectrum shows local blood flow disorder, the flow rate varies; two cases of other imaging Methods Thrombosis of splenic vein was diagnosed by ultrasonography, and the signal of blood flow in the splenic vein was significantly reduced. In the other 4 cases, no obvious abnormal portal system was found by ultrasound, and was confirmed by other methods. Color Doppler ultrasound examination of the positive rate of prehypertensive portal hypertension was 5/9, missed diagnosis rate of 4/9. Conclusion Color Doppler ultrasound has some value in screening, diagnosis and follow-up of prehypertrophic portal hypertension. However, due to many factors, the rate of misdiagnosis is high. Careful observation of the portal system lumen structure and internal echo, blood flow changes, combined with other imaging studies and attention to clinical history, to further improve the detection rate and accurate diagnosis rate.