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肝硬化和门静脉高压患儿的多普勒评估与健康对照组的比较:一项分析性横断面研究。

Doppler assessment of children with liver cirrhosis and portal hypertension in comparison with a healthy control group: An analytical cross-sectional study.

作者信息

Riahinezhad Maryam, Rezaei Mohammadreza, Saneian Hosein, Famouri Fatemeh, Farghadani Maryam

机构信息

Department of Radiology, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.

Department of Pediatrics, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.

出版信息

J Res Med Sci. 2018 May 30;23:40. doi: 10.4103/jrms.JRMS_1085_17. eCollection 2018.

Abstract

BACKGROUND

Doppler ultrasonography (Doppler US) plays an important role in evaluating patients with liver cirrhosis. This study aims to investigate the hemodynamic alterations of hepatic artery and portal vein among children with liver cirrhosis and portal hypertension (esophageal varices).

MATERIALS AND METHODS

We conducted an analytical cross-sectional study in Imam Hossein Children's Hospital, Isfahan, Iran, in 2016. A number of 33 cirrhotic children with or without esophageal varices were selected through convenience sampling method to be compared with 19 healthy children as controls using color and spectral Doppler US.

RESULTS

Portal vein mean velocities were 15.03 ± 7.3 cm/s in cirrhotics, 16.47 ± 6.4 cm/s in controls ( = 0.51), 11.6 ± 4.7 cm/s in patients with varices, and 17.9 ± 7.3 cm/s in patients without varices ( = 0.015). Mean diameters of caudate lobe, portal vein, and splenic vein, as well as the mean values of liver and spleen span, were significantly higher in cirrhotic children. The frequency of flow reversal (hepatofugal flow) was not detected significantly different in cirrhotics. Peak systolic velocity, end diastolic velocity, pulsatility index, and resistive index for hepatic artery as well as liver vascular index were not significantly different in cirrhotics in comparison with controls.

CONCLUSION

Alterations in Doppler parameters of portal vein including diameter and velocity may be the helpful indicators of liver cirrhosis and esophageal varices in children, respectively. Parameters of hepatic artery may not differentiate children with liver cirrhosis.

摘要

背景

多普勒超声检查(Doppler US)在评估肝硬化患者中起着重要作用。本研究旨在调查肝硬化合并门静脉高压(食管静脉曲张)患儿肝动脉和门静脉的血流动力学改变。

材料与方法

2016年,我们在伊朗伊斯法罕的伊玛目侯赛因儿童医院进行了一项分析性横断面研究。通过便利抽样法选取33例有或无食管静脉曲张的肝硬化患儿,与19例健康儿童作为对照,采用彩色和频谱多普勒超声进行比较。

结果

肝硬化患儿门静脉平均流速为15.03±7.3cm/s,对照组为16.47±6.4cm/s(P = 0.51),有静脉曲张患儿为11.6±4.7cm/s,无静脉曲张患儿为17.9±7.3cm/s(P = 0.015)。肝硬化患儿的尾状叶、门静脉和脾静脉的平均直径,以及肝脏和脾脏的平均跨度值均显著更高。肝硬化患儿中血流逆转(肝外血流)的频率未检测到显著差异。与对照组相比,肝硬化患儿肝动脉的收缩期峰值流速、舒张末期流速、搏动指数和阻力指数以及肝脏血管指数均无显著差异。

结论

门静脉多普勒参数的改变,包括直径和流速,可能分别是儿童肝硬化和食管静脉曲张的有用指标。肝动脉参数可能无法区分肝硬化患儿。

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