Pinto-Silva R A, Abrantes W L, Antunes C M, Lambertucci J R
Faculdade de Medicina, UFMG, Belo Horizonte, Brasil.
Rev Inst Med Trop Sao Paulo. 1994 Jul-Aug;36(4):355-61. doi: 10.1590/s0036-46651994000400008.
The diagnostic value of real-time sonography in the study of portal hypertension was assessed in 66 patients with hepatosplenic schistosomiasis mansoni, all with Symmers's fibrosis and esophageal varices. Seventy-one individuals without schistosomiasis were selected as controls. The inner diameters of the portal vessels were measured by sonography in all patients and controls: splenoportography was also performed in the schistosomal group. Intra-splenic pressure was over 30 cm of water in 44 of 60 patients with schistosomiasis. The upper limit of normality for portal vessel diameters was set through receiver operating characteristic curve at 12 mm for portal vein, 9 mm for splenic vein at splenic hilus, and 9 mm for superior mesenteric vein. The best discriminative vein for the diagnosis of portal hypertension was the splenic vein followed by the portal vein. A direct correlation was observed between the diameter of the splenic vein, measured by sonography, and the intra-splenic pressure. Except for the paraumbilical and mesenteric veins, more frequently identified by sonography, there was no statistical difference in the frequency of visualization of splanchnic vessels by sonography or splenoportography.
对66例曼氏血吸虫病肝脾型患者进行实时超声检查，评估其在门静脉高压研究中的诊断价值，所有患者均有席默斯氏纤维化和食管静脉曲张。选取71例无血吸虫病的个体作为对照。对所有患者和对照进行超声测量门静脉内径：血吸虫病组还进行了脾门静脉造影。60例血吸虫病患者中有44例脾内压超过30厘米水柱。通过受试者工作特征曲线确定门静脉内径正常上限为12毫米，脾门处脾静脉为9毫米，肠系膜上静脉为9毫米。诊断门静脉高压的最佳鉴别静脉是脾静脉，其次是门静脉。超声测量的脾静脉直径与脾内压之间存在直接相关性。除了超声更常发现的脐旁静脉和肠系膜静脉外，超声或脾门静脉造影对内脏血管的显示频率无统计学差异。
