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肝静脉超声在肝硬化早期检测中的诊断价值

Diagnostic Value of Hepatic Vein Ultrasound in Early Detection of Liver Cirrhosis.

作者信息

Zare Marzouni Hadi, Davachi Behrooz, Rezazadeh Mahdi, Salehi Milani Mahmoud, Matinfard Sedighe

机构信息

Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Galen Med J. 2018 Aug 11;7:e1140. doi: 10.22086/gmj.v0i0.1140. eCollection 2018.

Abstract

BACKGROUND

Cirrhosis is a common disease that destroys liver cells, and it has various etiologies. The early diagnosis of cirrhosis can be effective in improving prognosis. Considering the availability and affordability of ultrasound devices throughout the world, in this study we evaluated the diagnostic value of hepatic vein ultrasound examination in the early detection of liver cirrhosis.

MATERIALS AND METHODS

In this study, 45 patients referred to the radiology department of Ghaem Hospital for liver biopsy were evaluated for changes in the hepatic veins under ultrasound with a transducer of 5-7MHz. One piece of the hepatic vein was selected for ultrasound, and the wall of hepatic veins was examined for straightness and uniformity of echogenicity. Subsequently, patients underwent biopsy by ultrasound guide. Of all the study subjects, eight patients presented mild chronic hepatitis without fibrosis, four patients were diagnosed with fatty liver, and 33 patients had severe cirrhosis or chronic hepatitis with fibrosis.

RESULTS

Our results showed that hepatitis patients with or without fibrosis had irregular and wavy hepatic vein wall (impairment in straightness) with non-uniform echo (impairment in uniformity of echogenicity). While patients without hepatitis and cirrhosis, but diagnosed with fatty liver, had a smooth and regular hepatic vein wall with a uniform echo.

CONCLUSION

The present study showed that hepatic vein examination in terms of echogenicity and straightness could be used to diagnose hepatitis, its severity as well as its course towards fibrosis and cirrhosis.

摘要

背景

肝硬化是一种破坏肝细胞的常见疾病,病因多样。肝硬化的早期诊断有助于改善预后。鉴于全球超声设备的可及性和可承受性,本研究评估了肝静脉超声检查在肝硬化早期检测中的诊断价值。

材料与方法

本研究中,对45名转诊至加姆医院放射科进行肝活检的患者,使用5-7MHz探头在超声下评估肝静脉的变化。选择一条肝静脉进行超声检查,观察肝静脉壁的平整度和回声均匀性。随后,患者在超声引导下进行活检。在所有研究对象中,8名患者为轻度慢性肝炎无纤维化,4名患者被诊断为脂肪肝,33名患者患有严重肝硬化或伴有纤维化的慢性肝炎。

结果

我们的结果显示,有或无纤维化的肝炎患者肝静脉壁不规则且呈波浪状(平整度受损),回声不均匀(回声均匀性受损)。而无肝炎和肝硬化但被诊断为脂肪肝的患者,肝静脉壁光滑规则,回声均匀。

结论

本研究表明,从回声性和平整度方面进行肝静脉检查可用于诊断肝炎、其严重程度以及向纤维化和肝硬化发展的进程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b98f/8343969/7b922b68be24/gmj-7-e1140-g001.jpg

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