超声造影评价肝硬化血流灌注特征的初步研究

目的 探讨超声造影评价肝硬化血流灌注特征的临床应用价值.方法选择慢性乙肝患者60例,其中无肝硬化（无肝硬化组）30例,肝硬化（肝硬化组）30 例;正常对照组20例.无肝硬化组、肝硬化组和正常对照组应用六氟化硫微泡混悬液在低机械指数条件下进行超声造影检查,观察肝动脉、门静脉、肝静脉和肝实质的显影动态过程,记录门静脉开始显影时间（PVAT）、肝静脉开始显影时间（HVAT）、门静脉达峰值时间（PVPT）和肝静脉达峰值时间（HVPT）和门静脉-肝静脉渡越时间（PV-HVTT）.分析无肝硬化组、肝硬化组和正常对照组上述各参数差异有无统计学意义.结果 3组PVAT、PVPT和HVPT比较差异无统计学意义（P＞0.05）,肝硬化组HVAT、PV-HVTT均较正常对照组、无肝硬化组显著缩短（均P＜0.05）.结论 超声造影定量参数HVAT和PV-HVTT可反映肝硬化微循环及血流动力学改变,为临床早期诊断肝硬化提供依据.同时,可以更好地指导临床治疗.

Assessment of Blood Perfusion with Contrast-Enhanced Ultrasound in Patients with Hepatic Cirrhosis

Objective To explore the clinical value of contrast-enhanced ultrasound（CEUS） in assessing blood perfusion characteristics in patients with hepatic cirrhosis. Methods Sixty pati ents with chronic hepatitis B. CEUS was performed in 30 chronic hepatitis B patients without liver cirrhosis（non-cirrhosis group）, 30 chronic hepatitis B patients with liver cirrhosis （cirrhosis group） and 20 normal subjects（normal control group）. Dynamic visualization of hepatic artery, portal vein,hepatic vein and liver parenchyma was achieved by using an aqueous suspension of sulfur hexafluoride microbubbles under the condition of low mechanical index. The contrast mate- rial to portal vein arrival time（PVAT）, hepatic vein arrival time（HVAT）,portal vein peak time （PVPT） ,hepatic vein peak time（HVPT） and portal vein to hepatic vein transit time（PV-HVTT） were recorded. Differences in these parameters were statistically analyzed among the three groups. Results There were no significant differences in PVAT, PVPT and HVPT among the three groups（P〈0.05）. Compared with normal control group or non-cirrhosis group, HVAT and PV-HVTT significantly decreased in cirrhosis group （P〈 0.05）. Conclusion HVAT and PV- HVTT reflect the changes in microcirculation and hemodynamics and provide the basis for early diagnosis and clinic treatment of hepatic cirrhosis.