Mitraite Dalia, Krimelis Adrijus
Kauno medicinos universiteto Radiologijos klinika, Eiveniu 2, 3007 Kaunas.
Medicina (Kaunas). 2002;38(2):205-9.
Doppler-based sonography investigation of liver blood circulation plays major role in the modern diagnosis of portal hypertension that is frequently caused by portal vein thrombosis. Eight patients with portal vein thrombosis have been investigated. During the sonographic investigation we evaluated the size of liver, focal changes in liver, the diameters of the portal vein and its both branches, of the spleen vein, of the superior mesenteric vein, the direction and the characteristics of the blood flow, portaportic and portasystemic collaterals, and the size of spleen. The thrombosis of the trunk and both branches of the portal vein was detected in 4 patients, out of which there was one case of additional thrombosis of the spleen and the superior mesenteric veins, while in another case there was partial thrombosis of the spleen vein. A separate thrombus of the portal vein trunk was noticed in 1 patient. The thrombosis of the portal vein trunk and the right branch was diagnosed in 1 case. There were 2 cases of thrombosis of only left branch of the portal vein. The cause of the portal vein thrombosis remained undetected in 6 cases. The thrombosis of the portal vein developed as a consequence of pancreatitis in one patient, the cause of another case was hepatocellular carcinoma. In comparison to CT, sonography is able to determine additionally the direction of the blood flow and to record a variety of different sections in detecting the above-mentioned pathology. Doppler-based sonography investigation of liver blood circulation, especially the color-coded, is non-invasive, it can be carried out quickly and does not need expensive contrast medium.
基于多普勒的肝脏血液循环超声检查在门静脉高压的现代诊断中起着重要作用,门静脉高压常由门静脉血栓形成引起。对8例门静脉血栓形成患者进行了检查。在超声检查过程中,我们评估了肝脏大小、肝脏局灶性改变、门静脉及其两个分支、脾静脉、肠系膜上静脉的直径、血流方向和特征、门静脉与门静脉之间以及门静脉与体循环之间的侧支循环以及脾脏大小。4例患者检测到门静脉主干及其两个分支血栓形成,其中1例合并脾静脉和肠系膜上静脉血栓形成,另1例为脾静脉部分血栓形成。1例患者发现门静脉主干单独血栓形成。1例诊断为门静脉主干及右分支血栓形成。2例仅门静脉左支血栓形成。6例患者门静脉血栓形成的原因未查明。1例患者门静脉血栓形成是胰腺炎的结果,另1例的病因是肝细胞癌。与CT相比,超声检查能够额外确定血流方向,并在检测上述病变时记录各种不同的切面。基于多普勒的肝脏血液循环超声检查,尤其是彩色编码检查,是非侵入性的,可以快速进行,且不需要昂贵的造影剂。