CAJ | 학술논문

目的探讨超声造影及彩色多普勒参数在门静脉高压食管静脉曲张的诊断价值。方法根据胃镜检查结果,将29例无食管静脉曲张的正常人设为对照组,60例食管静脉曲张的患者均分为中重度组及轻度组,3组分别接受彩色多普勒及超声造影检查,采集肝内血流循环动态数据,获得时间-强度曲线( TIC曲线),得到以下定量参数：肝静脉减震指数( DI )、门静脉流速( PVV )、造影剂肝动脉到达时间( HAAT)、门静脉到达时间( PVAT )及肝静脉到达时间( HVAT),进而计算造影剂肝动脉门静脉间隔时间( PV-HA,即造影剂到达门静脉时间减去到达肝动脉时间)及肝静脉门静脉间隔时间( PV-HV,即造影剂到达门静脉时间减去到达肝静脉时间)。结果 PV-HV、PV-HA、PVV、DI在3组之间差异有统计学意义( F =72.63、14.97、6.71、13.74, P <0.01)。中重度组与对照组比较,PV-HV、PV-HA、PVV、DI差异有统计学意义(P<0.01),与轻度组比较,PV-HV、PV-HA、DI差异有统计学意义( P<0.01),而PVV差异无统计学意义。轻度组与对照组比较,PV-HA差异有统计学意义( P<0.05),PV-HV、DI及PVV差异无统计学意义。结论利用超声造影及彩色多普勒诊断门静脉高压食管静脉曲张具有重要价值,有望成为其无创诊断的新方法。
목적탐토초성조영급채색다보륵삼수재문정맥고압식관정맥곡장적진단개치。방법근거위경검사결과,장29례무식관정맥곡장적정상인설위대조조,60례식관정맥곡장적환자균분위중중도조급경도조,3조분별접수채색다보륵급초성조영검사,채집간내혈류순배동태수거,획득시간-강도곡선( TIC곡선),득도이하정량삼수：간정맥감진지수( DI )、문정맥류속( PVV )、조영제간동맥도체시간( HAAT)、문정맥도체시간( PVAT )급간정맥도체시간( HVAT),진이계산조영제간동맥문정맥간격시간( PV-HA,즉조영제도체문정맥시간감거도체간동맥시간)급간정맥문정맥간격시간( PV-HV,즉조영제도체문정맥시간감거도체간정맥시간)。결과 PV-HV、PV-HA、PVV、DI재3조지간차이유통계학의의( F =72.63、14.97、6.71、13.74, P <0.01)。중중도조여대조조비교,PV-HV、PV-HA、PVV、DI차이유통계학의의(P<0.01),여경도조비교,PV-HV、PV-HA、DI차이유통계학의의( P<0.01),이PVV차이무통계학의의。경도조여대조조비교,PV-HA차이유통계학의의( P<0.05),PV-HV、DI급PVV차이무통계학의의。결론이용초성조영급채색다보륵진단문정맥고압식관정맥곡장구유중요개치,유망성위기무창진단적신방법。
Objective To discuss the value of contrast-enhanced ultrasound and color Doppler in diagnosing esoph-ageal varices( EV) among patients suffering from portal hypertension. Methods The control group consisted of twenty nine patients without EV. Sixty patients with EV diagnosed by endoscopy were divided into two groups equal in number according to grade of EV. One being mild,the other was moderate to severe. All patients underwent color Doppler flow imaging and contrast-enhanced ultrasound, and the dynamic angiography data were collected. Time-in-tensity curves were drawn by software. The quantitative parameters including arrival time of hepatic artery ( HAAT) ,hepatic vein ( HVAT) and portal vein ( PVAT) ,damping index ( DI) of hepatic vein and portal vein ve-locity( PVV) were compared. Results The difference of PV-HV, PV-HA, PVV, DI showed statistically signifi-cant among the three groups(F=72.63,14.97,6.71,13.74,P<0.01). A comparison of the control and moderate to severe group among the above four parameters was statistically significant (P<0.01). PV-HV, PV-HA, DI in moderate to severe group showed statistically significant compared with mild group (P<0.01),however there exis-ted no significant difference grouping PVV between the two groups. Mild group contrasted to the control group,the differences of PV-HA were statistically significant (P<0.01), whereas PV-HV, DI, PVV displayed no significant difference. Conclusion Contrast-enhanced ultrasound and color Doppler are helpful in diagnosing EV,which is ex-pected to become a new noninvasive method.