柏—查综合征的彩色多普勒超声诊断价值
【摘要】 目的:探讨彩色多普勒超声在柏—查综合征中的诊断价值。方法:采用彩色多普勒对18例柏—查综合征患者进行检测,并提示客观的超声诊断。结果:下腔静脉阻塞型7例(38.89%),肝静脉阻塞型6例(33.33%),混合型5例(27.78%)。结论:彩色多普勒超声能显示柏—查综合征的声像图表现,在柏—查综合征的治疗过程中可连续、实时地对患者进行术前、术中及术后监测,可作为柏—查综合征的首选诊断方法。
Diagnostic Value of Color Doppler Ultrasound in BuddChiari Syndrome。
Abstract: Objective To explore the diagnotic value of color doppler ultrasound in BuddChiari syndrome. Methods 60 cases of patients suffer with BuddChiari syndrome were detected by color doppler ultrasound and made the diagnosis. Results There are 18 cases of BuddChiari syndrome, 9 cases were diagnosed inferior vena cava obstruction and the rate was 38.89% ,6 cases were diagnosed endophlebites hepatica obliterans and the rate was 33.33%,5 cases were diagnosed mixed pattern and the rate was 27.78%. Conclution The echogram expression of BuddChiari syndrome could be displayed by color doppler ultrasound,it can inspect the patients continuously and realtime before,during and after the surgery in the process of treatment of BuddChiari syndrome.
Key words: BuddChiari syndrome; Color doppler ultrasound diagnosis; Value。
柏—查综合征是肝静脉和(或)其开口以及肝段下腔静脉阻塞病变所引起的门静脉高压症。以往诊断手段主要依靠血管照影技术,近年来彩色多普勒超声作为方便快捷无创的诊断方法逐步推广,我们自1998年8月至2006年8月利用彩色多普勒超声确诊柏—查综合征18例,总结报道如下。
1 资料与方法。
柏—查综合征患者18例,男12例,女6例;年龄18岁~52岁,平均年龄35岁。肝肿大16例,脾肿大16例;大量腹水6例;下肢静脉曲张5例,双下肢浮肿4例。病程最长4 a,最短半月。使用仪器为美国产泰索尼及日本产阿洛卡α10彩色多普勒超声诊断议,探头频率3.5 MHz,患者取平卧位、左侧卧位、右侧卧位或直立位,空腹6 h,常规扫描肝、脾、下腔静脉、肝静脉等,主要观察下腔静脉有无膜性阻塞及节段性阻塞、肝静脉开口处有无阻塞及肝静脉广泛阻塞、是否伴副肝静脉闭塞等。
2 结果。
2.1 下腔静脉阻塞型 7例,其中下腔静脉膜性阻塞4例,下腔静脉节段性阻塞3例;其二维声像图表现:阻塞远端管腔扩张,肝脏高度肿大,膜性阻塞者可见横形或斜形的薄膜回声光带,断面呈“H”形改变。有2例可见附于管壁的边界清楚的向管腔内突出的实质性回声光团或光带,提示下腔静脉内血栓形成。7例患者多普勒超声表现:2例完全阻塞者,阻塞处无血流信号显示;1例下腔静脉右房入口处狭窄,局部血流成喷射状彩色花色血流;2例显示栓子附着出的彩色充盈缺损;有4例下腔静脉管腔表现有局部膨大,呈缓慢旋转血流。