CAJ | 학술논문

目的探讨超声造影无创评估门静脉压力的可行性.方法对18例拟行脾切除与贲门周围血管离断术的门静脉高压症患者(PHT组)于术前1周内进行肝超声造影,并以20例健康志愿者作为对照组.以肝肾切面为感兴趣区,通过时间强度曲线分别计算门静脉-肝动脉曲线下面积比(Qp/Qa)和门静脉-肝动脉灌注强度比(Ip/Ia).对PHT患者经由术中门静脉穿刺获取门静脉压力,并进一步分析其与上述参数的关系.结果 PHT组与对照组,Qp/Qa分别为2.28±0.66、5.72±3.69,Ip/Ia分别为0.35±0.14、1.97±0.17,差异均有统计学意义.PHT组Qp/Qa和Ip/Ia与门静脉压力呈负相关(P＜0.01),其相关系数分别为-0.747和-0.617.两者关系的直线回归方程分别为Y=-83X +5.013,Y=-15X+0.837.结论肝超声造影参数Qp/Qa和Ip/Ia与门静脉压力有良好的相关性,有望成为临床无创评估门静脉压力的新方法.
목적 탐토초성조영무창평고문정맥압력적가행성.방법 대18례의행비절제여분문주위혈관리단술적문정맥고압증환자(PHT조)우술전1주내진행간초성조영,병이20례건강지원자작위대조조.이간신절면위감흥취구,통과시간강도곡선분별계산문정맥-간동맥곡선하면적비(Qp/Qa)화문정맥-간동맥관주강도비(Ip/Ia).대PHT환자경유술중문정맥천자획취문정맥압력,병진일보분석기여상술삼수적관계.결과 PHT조여대조조,Qp/Qa분별위2.28±0.66、5.72±3.69,Ip/Ia분별위0.35±0.14、1.97±0.17,차이균유통계학의의.PHT조Qp/Qa화Ip/Ia여문정맥압력정부상관(P＜0.01),기상관계수분별위-0.747화-0.617.량자관계적직선회귀방정분별위Y=-83X +5.013,Y=-15X+0.837.결론 간초성조영삼수Qp/Qa화Ip/Ia여문정맥압력유량호적상관성,유망성위림상무창평고문정맥압력적신방법.
Objective To investigate the feasibility of non-invasive quantitative evaluation of portal pressure (Pp) by contrast enhanced ultrasonography (CEUS).Methods 18 portal hypertension patients (PTH group) were performed with CEUS within one week before splenectomy and pericardial devascularization,and 20 healthy volunteers as controls were recruited in this study (control group).Hepatic-right kidney sectionwas chosen to calculate the area under curve of portal vein/hepatic artery (Qp/Qa) and the perfusion intensity of portal vein/hepatic artery (Ip/Ia) through time intensity curves (TIC) of liver parenchyma generated from CEUS images.Pp was measured by intra-operative mesenteric vein catheter,and the correlation betweenPp and Qp/Qa,Ip/Ia were analyzed by Pearson correlation test.Results The levels of Qp/Qa and Ip/Ia in the PTH group were 2.28 ± 0.66 and 0.35 ± 0.14 respectively,which were both significantly declined than that in the controlgroup (5.72 ± 3.69 and 1.97 ± 0.17).In the PTH group,the correlation coefficient were-0.747 and-0.617,and the linear regression equations were Y =-83 X + 5.013 andY =-15X + 0.837,which indicated that Qp/Qa and Ip/Ia had significant correlation with Pp.Conclusions CEUS parameters,including Qp/Qa and Ip/Ia,are significantly correlated to Pp in portal hypertension patients,which indicate that CEUS could be a new non-invasive clinical method for evaluating Pp.