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定量分析增强超声估计单支肝外门体分流犬的肝内门脉血流。

Quantitative analysis of contrast-enhanced ultrasound estimates intrahepatic portal vascularity in dogs with single extrahepatic portosystemic shunt.

出版信息

Am J Vet Res. 2022 May 8;83(6):ajvr.21.10.0155. doi: 10.2460/ajvr.21.10.0155.

DOI:10.2460/ajvr.21.10.0155
PMID:35524960
Abstract

OBJECTIVE

To evaluate the clinical impact on quantitative analysis of contrast-enhanced ultrasound (CEUS) on single extrahepatic portosystemic shunt (PSS) in dogs.

ANIMALS

21 client-owned dogs with single extrahepatic PSS and 5 healthy Beagles.

PROCEDURES

In all dogs, CEUS was performed to calculate the rising time (RT), rising rate (RR), and portal vein-to-hepatic parenchyma transit time (ΔHP-PV) from the time-intensity curve obtained in the hepatic parenchyma and portal vein. All dogs in the PSS group underwent preoperative CT angiography (CTA) and surgery. The CEUS variables in the PSS group were compared with those in the healthy dogs (control group) and were analyzed for shunt types and grades of intrahepatic portal venous branches based on CTA findings, intraoperative portal pressure, and surgical procedures.

RESULTS

All 3 CEUS variables showed no significant differences between the PSS and control groups. The RT and ΔHP-PV in the left gastrophrenic shunt group were significantly longer than in the other shunt types. In the intrahepatic portal vascularity, the RT in grade 1 was significantly shorter than in grades 3 and 4, and the RR in grade 1 was significantly higher than in grade 4. The RT and ΔHP-PV were significantly correlated with portal pressure variables. The RT in dogs with partial ligation was significantly shorter than in dogs with complete ligation and percutaneous transvenous coil embolization.

CLINICAL RELEVANCE

Quantitative assessments of CEUS may be useful for estimating intrahepatic portal vascularity in dogs with single extrahepatic PSS.

摘要

目的

评估对比增强超声(CEUS)定量分析对犬单支肝外门体分流(PSS)的临床影响。

动物

21 只患有单支肝外 PSS 的患犬和 5 只健康比格犬。

操作步骤

所有犬均行 CEUS,以计算肝实质和门静脉时间-强度曲线得出的上升时间(RT)、上升率(RR)和门静脉-肝实质通过时间(ΔHP-PV)。PSS 组的所有犬均行术前 CT 血管造影(CTA)和手术。比较 PSS 组的 CEUS 变量与健康犬(对照组)的 CEUS 变量,并根据 CTA 结果、术中门静脉压力和手术过程分析肝内门静脉分支的分流类型和分级。

结果

3 项 CEUS 变量在 PSS 组和对照组之间均无显著差异。左胃膈分流组的 RT 和 ΔHP-PV 明显长于其他分流类型。在肝内门静脉血流中,1 级的 RT 明显短于 3 级和 4 级,1 级的 RR 明显高于 4 级。RT 和 ΔHP-PV 与门静脉压力变量显著相关。部分结扎犬的 RT 明显短于完全结扎和经皮经静脉线圈栓塞犬。

临床意义

CEUS 的定量评估可能有助于评估犬单支肝外 PSS 患者的肝内门静脉血流情况。

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