Clinical application value of contrast-enhanced ultrasound in hepatic artery thrombosis after pediatric liver transplantation
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摘要:
目的 探讨超声造影(CEUS)在儿童肝移植术后肝动脉血栓(HAT)中的临床应用价值。 方法 回顾性分析126例儿童肝移植受者的临床资料,总结儿童肝移植术后HAT发生情况,比较HAT的彩色多普勒超声和CEUS表现。 结果 彩色多普勒超声高度怀疑HAT者17例,CEUS诊断HAT者9例,其中CEUS提示HAT的9例受者均经CT血管造影(CTA)或手术证实诊断。HAT的CEUS表现为肝动脉在动脉期乃至门静脉期在门静脉周围未见显影,4例HAT患者发生肝细胞坏死,CEUS表现为肝内造影剂无灌注。 结论 CEUS在儿童肝移植术后HAT的诊断中有较高的临床应用价值,与传统CTA相比优势明显,可以在临床广泛推广。 -
关键词:
- 儿童肝移植 /
- 超声造影(CEUS) /
- 肝动脉血栓(HAT) /
- CT血管造影(CTA) /
- 数字减影血管造影术(DSA) /
- 造影剂 /
- 肝内梗死灶 /
- 影像学检查
Abstract:Objective To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) in hepatic artery thrombosis (HAT) after pediatric liver transplantation. Methods Clinical data of 126 pediatric recipients undergoing liver transplantation were retrospectively analyzed. The incidence of HAT after pediatric liver transplantation was summarized. Color Doppler ultrasound and CEUS manifestations of HAT were compared. Results According to color Doppler ultrasound, 17 cases were highly suspected with HAT. Nine cases were highly suspected with HAT by CEUS, who were subsequently confirmed by CT angiography (CTA) or surgery. CEUS manifestations of HAT showed that hepatic artery was not seen surrounding the portal vein during the arterial phase or even portal venous phase. Hepatocyte necrosis occurred in 4 patients with HAT, and no perfusion of intrahepatic contrast agent was observed on CEUS. Conclusions CEUS yields high clinical application value in the diagnosis of HAT after pediatric liver transplantation. It has significant advantages compared with traditional CTA, which could be widely applied in clinical practice. -
表 1 HAT确诊患者基本资料
Table 1. Basic information of patients diagnosed with HAT
例序 性别 年龄(月) 术前诊断 术后发生时间(d) CEUS诊断结果 确诊方式 1 男 16 胆道闭锁 30 HAT CTA 2 男 12 胆道闭锁 4 HAT CTA 3 女 46 胆道闭锁 1 HAT CTA 4 女 6 Caroli病 5 HAT CTA 5 女 5 胆道闭锁 1 HAT 手术 6 男 6 胆道闭锁 4 HAT 手术 7 男 15 胆道闭锁 20 HAT CTA 8 男 9 胆道闭锁 3 HAT 手术 9 男 6 胆道闭锁 2 HAT 手术 -
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