Ralls P W
Department of Radiology, University of Southern California Medical School, Los Angeles.
AJR Am J Roentgenol. 1990 Sep;155(3):517-25. doi: 10.2214/ajr.155.3.2117348.
Color Doppler sonography is an important noninvasive diagnostic tool for detecting abnormalities of the hepatic vasculature in patients with diffuse liver disease. To study its usefulness in these cases, we retrospectively reviewed the findings in 147 patients with abnormal portal venous color Doppler sonograms. This group comprised all patients with abnormal portal venous color Doppler sonograms studied from February 1987 to July 1989. Correlative imaging was not available in all cases. The sonographic diagnoses included (1) portal venous thrombosis (50 patients, 93 vessels); (2) portal-systemic or portal-portal collaterals (80 patients, 95 collaterals); (3) reversed, bidirectional, or other abnormal portal venous flow patterns (36 patients); and (4) abnormal hepatic arterial flow (20 patients). Since the results reported derive from a retrospective review without consistent correlation with other imaging studies, no appraisal of the sensitivity or accuracy of portal color Doppler sonography could be made from our data. The ability of color Doppler sonography to visualize flow without altering hemodynamics has led to several novel observations in these patients. These include increased arterial flow in states of low portal blood flow, reversal of portal flow direction postprandially, coincident reversed and hepatopetal flow in different branches of a single portal vein, and normal helical portal venous flow. These and other findings show that color Doppler sonography has enhanced our ability to detect abnormalities of the hepatic and portal venous system.
彩色多普勒超声检查是检测弥漫性肝病患者肝血管异常的一种重要的非侵入性诊断工具。为研究其在这些病例中的实用性，我们回顾性分析了147例门静脉彩色多普勒超声检查异常患者的检查结果。该组包括1987年2月至1989年7月期间所有接受门静脉彩色多普勒超声检查且结果异常的患者。并非所有病例都有相关的影像学检查结果。超声诊断包括：（1）门静脉血栓形成（50例患者，93条血管）；（2）门体或门门分流（80例患者，95处分流）；（3）门静脉血流方向反向、双向或其他异常血流模式（36例患者）；（4）肝动脉血流异常（20例患者）。由于报告的结果来自回顾性分析，且未与其他影像学检查进行一致的相关性分析，因此我们的数据无法对门静脉彩色多普勒超声检查的敏感性或准确性进行评估。彩色多普勒超声检查能够在不改变血流动力学的情况下可视化血流，这在这些患者中带来了一些新的发现。这些发现包括门静脉血流低时动脉血流增加、餐后门静脉血流方向逆转、单条门静脉不同分支中血流反向与向肝血流同时存在以及门静脉正常的螺旋血流。这些以及其他发现表明，彩色多普勒超声检查增强了我们检测肝静脉和门静脉系统异常的能力。
