Ma Lin, Peng Chihan, Yang Lulu, Zhu Xiaoxia, Fan Hongxia, Yang Jiali, Wang Hong, Luo Yan
West China Hospital of Sichuan University, Department of Ultrasound, Sichuan, China.
West China Tian Fu Hospital, Sichuan University, Department of Ultrasound, Sichuan, China.
Diagn Interv Radiol. 2025 Mar 3;31(2):68-74. doi: 10.4274/dir.2024.242912. Epub 2024 Nov 25.
To evaluate the diagnostic value of ultrasound in grading portal vein stenosis (PVS) in a rat model of 70% partial hepatectomy (PH).
A total of 96 Sprague-Dawley rats were randomly divided into a PH group and PVS groups with mild, moderate, and severe PVS following PH. Hemodynamic parameters were measured using high-frequency ultrasound (5-12 MHz high-frequency linear transducer), including pre-stenotic, stenotic, and post-stenotic portal vein diameters (PVD, PVD, PVDpost); pre-stenotic and stenotic portal vein velocity (PVVpre, PVVs); hepatic artery peak systolic velocity (PSV); end-diastolic velocity; and resistive index. The portal vein diameter ratio (PVDR) and portal vein velocity ratio (PVVR) were calculated using the following formulas: PVDR=PVD/PVD and PVVR=PVVs/PVVpre. The value of these parameters in grading PVS was assessed.
Portal vein hemodynamics showed gradient changes as PVS aggravated. For identifying >50% PVS, PVD and PVDR were the best parameters, with areas under the curve (AUC) of 0.85 and 0.86, respectively. For identifying >65% PVS, PVD, PVDR, and PVVR were relatively better, with AUCs of 0.94, 0.85, and 0.88, respectively. The AUC of hepatic artery PSV for identifying >65% PVS was 0.733.
High-frequency ultrasonography can be used to grade PVS in rats, with PVD, PVDR, and PVVR being particularly useful. Hepatic artery PSV may help in predicting >65% PVS. These findings provide valuable information for PVS rat model research and offer an experimental basis for further studies on PVS evaluation in living-donor liver transplantation (LDLT).
Ultrasonography serves as a first-line technology for diagnosing PVS following LDLT. However, the grading criteria for PVS severity remain unclear. Investigating the use of ultrasonic hemodynamics in the early diagnosis of PVS and grading stenosis severity is important for early postoperative intervention and improving recipient survival rates.
评估超声在70%部分肝切除术（PH）大鼠模型中门静脉狭窄（PVS）分级的诊断价值。
将96只Sprague-Dawley大鼠随机分为PH组和PH术后轻度、中度和重度PVS的PVS组。使用高频超声（5-12MHz高频线性换能器）测量血流动力学参数，包括狭窄前门静脉直径（PVDpre）、狭窄处门静脉直径（PVDs）和狭窄后门静脉直径（PVDpost）；狭窄前门静脉流速（PVVpre）和狭窄处门静脉流速（PVVs）；肝动脉收缩期峰值流速（PSV）；舒张末期流速；以及阻力指数。门静脉直径比（PVDR）和门静脉流速比（PVVR）采用以下公式计算：PVDR = PVDs/PVDpre，PVVR = PVVs/PVVpre。评估这些参数在PVS分级中的价值。
随着PVS加重，门静脉血流动力学呈梯度变化。对于识别>50%的PVS，PVD和PVDR是最佳参数，曲线下面积（AUC）分别为0.85和0.86。对于识别>65%的PVS，PVD、PVDR和PVVR相对较好，AUC分别为0.94、0.85和0.88。肝动脉PSV识别>65% PVS的AUC为0.733。
高频超声可用于大鼠PVS分级，PVD、PVDR和PVVR尤其有用。肝动脉PSV可能有助于预测>65%的PVS。这些发现为PVS大鼠模型研究提供了有价值的信息，并为活体肝移植（LDLT）中PVS评估的进一步研究提供了实验依据。
超声检查是LDLT后诊断PVS的一线技术。然而，PVS严重程度的分级标准仍不明确。研究超声血流动力学在PVS早期诊断和狭窄严重程度分级中的应用，对于早期术后干预和提高受者生存率具有重要意义。
