Department of Ultrasound, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China.
Department of General Surgery, Nanhu District, China-Japan Union Hospital, Jilin University, Changchun, Jilin, China.
Ultrasound Med Biol. 2021 Feb;47(2):272-278. doi: 10.1016/j.ultrasmedbio.2020.10.001. Epub 2020 Nov 2.
The aim of the study described here was to explore the value of hepatic transit time (HTT) and shear wave velocity (SWV) in diagnosing cirrhotic portal hypertension. Fifty-seven patients had undergone esophagogastric varicose vein embolization (group OBS) and 50 healthy controls (group CON) were retrospectively compared with respect to HTT (arterial-hepatic vein [HA-HVTT], portal vein-hepatic vein [PV-HVTT], liver parenchyma-hepatic vein [PA-HVTT]) and SWV to analyze their efficacy in diagnosing cirrhotic portal hypertension. The correlations between SWV/HTT and free portal pressure (FPP) in group OBS were also analyzed. Compared with group CON, group OBS had a shorter HTT and faster SWV. The area under the curve (AUC) of PV-HVTT (0.93) was higher than those of HA-HVTT (0.75) and PA-HVTT (0.64), the AUCs of PV-HVTT (0.93, threshold 7.9 s) and SWV (0.91, threshold 2.0 cm/s) did not statistically differ (z = 0.35, p = 0.73). HTT and FPP in group OBS had a negative correlation. In conclusion, HTT and SWV can be used to diagnose cirrhotic portal hypertension without difference in diagnostic efficacy, and HTT is more meaningful for assessing the changes in portal pressure.
本研究旨在探讨肝转运时间(HTT)和剪切波速度(SWV)在诊断肝硬化门静脉高压症中的价值。57 例患者接受了食管胃静脉曲张栓塞术(观察组),并回顾性比较了 50 例健康对照者(对照组)的 HTT(动脉-肝静脉 [HA-HVTT]、门静脉-肝静脉 [PV-HVTT]、肝实质-肝静脉 [PA-HVTT])和 SWV,分析其在诊断肝硬化门静脉高压症中的效能。还分析了观察组中 SWV/HTT 与自由门静脉压(FPP)之间的相关性。与对照组相比,观察组的 HTT 更短,SWV 更快。PV-HVTT(0.93)的曲线下面积(AUC)高于 HA-HVTT(0.75)和 PA-HVTT(0.64),PV-HVTT(0.93,阈值 7.9 s)和 SWV(0.91,阈值 2.0 cm/s)的 AUC 无统计学差异(z=0.35,p=0.73)。观察组中 HTT 与 FPP 呈负相关。总之,HTT 和 SWV 可用于诊断肝硬化门静脉高压症,其诊断效能无差异,HTT 更有助于评估门静脉压力的变化。