CAJ | 학술논문

目的探讨Budd-Chiari综合征的超声造影特征及临床价值.方法回顾性分析32例BCS患者的二维超声、彩色多普勒超声和超声造影检查资料,重点观察下腔静脉、肝静脉血流显影的特点,全部患者经血管造影、介入或手术治疗证实.结果 BCS超声造影特征性表现为:下腔静脉和(或)肝静脉狭窄处局部血流形态变窄,阻塞处局部无增强；肝后段下腔静脉显影延迟或不显影,当狭窄或阻塞经治疗改善或解除后,肝后段下腔静脉显影时间明显缩短；三支肝静脉主支之间狭窄支与正常支显影时间无明显区别；能良好显示血管内血流边缘,有利于显示狭窄段管腔内形及腔内血流束的走行；能较好显示血管支架内血流信息；不存在角度依赖性,可提高低流量、低流速血流信号的检出率；不能提供血流方向的信息.结论超声造影能良好显示下腔静脉、肝静脉狭窄或阻塞的部位、范围和程度,尤其适用于下腔静脉或肝静脉阻塞与重度狭窄的鉴别,这对手术方式的选择、治疗效果的判断和术后随访具有重要价值.
목적 탐토Budd-Chiari종합정적초성조영특정급림상개치.방법 회고성분석32례BCS환자적이유초성、채색다보륵초성화초성조영검사자료,중점관찰하강정맥、간정맥혈류현영적특점,전부환자경혈관조영、개입혹수술치료증실.결과 BCS초성조영특정성표현위:하강정맥화(혹)간정맥협착처국부혈류형태변착,조새처국부무증강；간후단하강정맥현영연지혹불현영,당협착혹조새경치료개선혹해제후,간후단하강정맥현영시간명현축단；삼지간정맥주지지간협착지여정상지현영시간무명현구별；능량호현시혈관내혈류변연,유리우현시협착단관강내형급강내혈류속적주행；능교호현시혈관지가내혈류신식；불존재각도의뢰성,가제고저류량、저류속혈류신호적검출솔；불능제공혈류방향적신식.결론 초성조영능량호현시하강정맥、간정맥협착혹조새적부위、범위화정도,우기괄용우하강정맥혹간정맥조새여중도협착적감별,저대수술방식적선택、치료효과적판단화술후수방구유중요개치.
Objective To study the characteristics and clinical value of contrast-enhanced ultrasound (CEUS) of Budd-Chiari syndrome(BCS).Methods The examination data of two-dimensional ultrasound and color Doppler ultrasound and CEUS of 32 patients with BCS retrospectively were analysed,the inferior vena cava,hepatic vein blood flow imaging characteristics were observed,all patients were confirmed by angiography and interventional treatment or surgery.Results The characteristic of CEUS of BCS:inferior vena cava and/or hepatic vein stenosis in local blood flow pattern turn narrowed,blocking local without enhancement.Post-hepatic inferior vena cava imaging was delayeds or not development,when the stenosis or obstruction was improved or removed after treatment,the post-hepatic inferior vena cava development time was significantly shortened.Development time had no obvious difference between narrow one and normal one among three main hepatic vein.Blood flow edge inner vessel can be well displayed,which is beneficial to show lunmen shape of narrow section and blood flow beam direction.The blood flow information inner vascular stent can be displayed.There was no angle dependence,can improve signal detection rate of low flow and low velocity blood flow.Conclusions CEUS can well display inferior vena cava,hepatic vein stenosis or obstruction with position,extent and degree,especially in identification of inferior vena cava or hepatic vein occlusion with severe stenosis,which has important value to the choice of operation method,the judgment of therapeutic effect and postoperative follow-up.