使用二维剪切波弹性成像评估肝外门静脉阻塞患者的脾脏硬度：与术中门静脉压力的比较。
Evaluation of Splenic Stiffness in Patients of Extrahepatic Portal Vein Obstruction Using 2D Shear Wave Elastography: Comparison with Intra-Operative Portal Pressure.
作者信息
Madhusudhan Kumble S, Kilambi Ragini, Pal Sujoy, Sharma Raju, Srivastava Deep N
机构信息
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India.
Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi 110029, India.
出版信息
J Clin Exp Hepatol. 2018 Sep;8(3):250-255. doi: 10.1016/j.jceh.2017.12.002. Epub 2017 Dec 30.
BACKGROUND/AIMS: To compare splenic stiffness (SS) with intra-operative portal pressures (PPs) in patients of extrahepatic portal vein obstruction (EHPVO).
METHODS
Twenty-one patients (14 males; 7 females) of mean age 20.4 years with clinical and sonographic diagnosis of EHPVO were included in this approved prospective study. Endoscopy for esophageal varices (EV) was done in all patients followed by ultrasonographic 2D shear wave elastography (SWE) of spleen. Three values were taken at different areas of spleen avoiding major vessels and mean was calculated. Intra-operative PP was measured from an omental vein during proximal spleno-renal shunt surgery. The PP was compared and correlated with SS along with other parameters.
RESULTS
The mean SS was 46.04 ± 8.0 kPa and the mean PP was 33.29 ± 4.1 mmHg. There was no significant correlation between PP and SS ( = 0.61) and between grades of EV and SS ( = 0.38). Significant correlation was seen between grades of EV and PP (0.04). SS also did not show significant correlation with splenic size or duration of disease.
CONCLUSION
SS measured by 2D SWE did not correlate with PP and thus may not help in predicting gastrointestinal bleed in patients of EHPVO.
背景/目的：比较肝外门静脉阻塞（EHPVO）患者的脾脏硬度（SS）与术中门静脉压力（PP）。
方法
本项经批准的前瞻性研究纳入了21例平均年龄20.4岁、临床及超声诊断为EHPVO的患者（14例男性；7例女性）。所有患者均接受了食管静脉曲张（EV）内镜检查，随后对脾脏进行超声二维剪切波弹性成像（SWE）。在脾脏不同区域避开主要血管获取三个值并计算平均值。在近端脾肾分流手术期间从网膜静脉测量术中PP。将PP与SS以及其他参数进行比较和相关性分析。
结果
平均SS为46.04±8.0 kPa，平均PP为33.29±4.1 mmHg。PP与SS之间（=0.61）以及EV分级与SS之间（=0.38）均无显著相关性。EV分级与PP之间存在显著相关性（0.04）。SS与脾脏大小或病程也无显著相关性。
结论
二维SWE测量的SS与PP不相关，因此可能无助于预测EHPVO患者的胃肠道出血。
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