Universidade do Estado do Amazonas, Fundação de Medicina Tropical Heitor Vieira Dourado, Gerência de Virologia, Manaus, Amazonas, Brazil.
Am J Trop Med Hyg. 2012 Feb;86(2):273-9. doi: 10.4269/ajtmh.2012.11-0561.
The purpose of this study was to correlate morphologic and hemodynamic Doppler ultrasound findings as indicators of the degree of inflammation and fibrosis and to diagnose chronic vital hepatitis complications and progression. A prospective, descriptive study of a case series was conducted that analyzed Doppler ultrasound images of the liver and portal system and used the portal vein congestion index, hepatic and splenic artery impedance indices, and the liver vascular index. Of 50 patients positive for antibodies against hepatitis C virus, morphologic changes highlighted increased hepatic parenchyma echogenicity in 24%, and increased gall blander echogenicity and wall thickness in 4%. The most common hemodynamic changes observed were reduced flow velocity in the portal vein trunk in 26%, congestion index changes in 12%, liver vascular index changes in 16%, and splenic and hepatic artery impedance index changes in 14%. These indices were shown to be associated with alanine aminotransferase levels, which suggested that they are important liver damage indicators in the early phase of infection with hepatitis C virus.
本研究旨在通过形态学和血流动力学多普勒超声表现的相关性，作为炎症和纤维化程度的指标，并诊断慢性活动性肝炎的并发症和进展。本研究为前瞻性病例系列描述性研究，分析了肝脏和门静脉系统的多普勒超声图像，并使用门静脉充血指数、肝脾动脉阻抗指数和肝血管指数。在 50 例丙型肝炎病毒抗体阳性的患者中，形态学变化突出表现为 24%的肝脏实质回声增强，4%的胆囊壁回声增强和壁增厚。最常见的血流动力学变化是门静脉主干流速降低 26%，充血指数改变 12%，肝血管指数改变 16%，脾肝动脉阻抗指数改变 14%。这些指标与丙氨酸氨基转移酶水平相关，表明它们是丙型肝炎病毒感染早期肝损伤的重要指标。
