| 卢春雨,唐少珊.彩色多普勒超声联合超声造影评价TIPS术后支架通畅性[J].中国介入影像与治疗学,2019,16(5):275-279 |
| 彩色多普勒超声联合超声造影评价TIPS术后支架通畅性 |
| Color Doppler combined with contrast-enhanced ultrasound in evaluation of stent patency after TIPS |
| 投稿时间：2018-09-17 修订日期：2019-02-02 |
| DOI：10.13929/j.1672-8475.201809033 |
| 中文关键词: 超声检查 门体分流术,经颈静脉肝内 支架 通畅性 |
| 英文关键词:ultrasonography portasystemic shunt, transjugular intrahepatic stents patency |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨彩色多普勒超声联合超声造影评价TIPS术后支架通畅性的价值，并分析TIPS术后支架内血流动力学特点。方法 回顾性分析32例TIPS术后患者的超声检查资料，观察并评价彩色多普勒超声及超声造影模式下支架通畅情况（分为0~3级）；测量支架门静脉端、中段、肝静脉端血流速度。分析不同超声检查方法评价TIPS术后支架通畅性的差异，并比较通畅性良好（3级）的支架不同部位间血流速度的差异。结果 不同超声检查方法间支架通畅性分级差异有统计学意义（Z=-3.589，P < 0.001）。8例次彩色多普勒超声显示支架轻度狭窄（2级）、6例次彩色多普勒超声显示支架重度狭窄（1级）及2例次彩色多普勒超声显示支架闭塞（0级），超声造影均显示支架通畅性良好（3级）。支架门静脉端[（71.52±36.84）cm/s]、中段[（94.35±39.94）cm/s]、肝静脉端[（99.83±32.63）cm/s]血流速度差异有统计学意义（F=22.617，P < 0.001）；且两两比较显示，支架中段（P=0.001）及肝静脉端（P < 0.001）血流速度均高于门静脉端。结论 彩色多普勒超声联合超声造影可提高评估TIPS术后支架通畅性的准确率。支架内不同位置血流速度存在一定差异。 |
| 英文摘要: |
| Objective To observe stent patency after TIPS with color Doppler and contrast-enhanced ultrasound, and to analyze the hemodynamic characteristics of the stent. Methods Postoperative ultrasonographic data of 32 patients underwent TIPS were retrospectively analyzed. The patency of stent was evaluated using color Doppler and contrast-enhanced ultrasound (defined into grade 0-3), and the flow velocities of the portal vein site, middle site and hepatic vein site of the stent were measured. Stent patency after TIPS was analyzed and compared between different ultrasound techniques, and the flow velocities in different sites of stent were compared in stents with excellent patency (grade 3). Results There was significantly statistical difference of stent patency between color Doppler ultrasound and contrast-enhanced ultrasound (Z=-3.589, P < 0.001). Contrast-enhanced ultrasound showed mild stenosis of stents (grade 2) in 8 times examination, severe stenosis (grade 1) in 6 times examination and stent occlusion in 2 times examination, while color Doppler ultrasound showed excellent patency (grade 3). There was significantly statistical difference of blood flow velocities among the portal vein site ([71.52±36.84]cm/s), middle site ([94.35±39.94]cm/s) and hepatic vein site([99.83±32.63]cm/s) of the stent (F=22.617, P < 0.001). Besides, the flow velocitie of middle site (P=0.001) and the hepatic vein site (P < 0.001) were respectively higher than that of portal vein site through pairwise comparison. Conclusion Color Doppler combined with contrast-enhanced ultrasound can improve the accuracy of the evaluation of stent patency after TIPS. Significant difference of flow velocities exist in different sites of the stent. |
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