Nicolau C, Brú C, Carreras E, Bosch J, Bianchi L, Gilabert R, Vilana R
Department of Radiology, Hospital Clínic i Provincial, Barcelona, Spain.
J Ultrasound Med. 1993 Aug;12(8):437-40. doi: 10.7863/jum.1993.12.8.437.
This study evaluated the role of duplex Doppler sonography in the diagnosis of VOD of the liver after bone marrow transplantation. Sixteen patients with clinical criteria of VOD were studied. The final diagnosis was achieved by transjugular liver biopsy, and the hepatic venous pressure gradient was measured during the procedure to estimate portal pressure. Nine patients (56.2%) had histologically proved VOD. Gallbladder wall thickening was present in 75% of patients with VOD, but in none of those without it (P = 0.01). Gallbladder wall thickening and ascites were present only in patients with portal hypertension. Nine patients (five with VOD and four without it) also were evaluated with duplex Doppler sonography, and no obvious flow abnormalities were detected in the portal vein and hepatic veins. These results suggest that sonography is useful in detecting early signs of portal hypertension pointing to the diagnosis of VOD in patients with bone marrow transplantation.
本研究评估了双功多普勒超声在诊断骨髓移植后肝静脉闭塞病（VOD）中的作用。对16例符合VOD临床标准的患者进行了研究。最终诊断通过经颈肝活检确定，并在操作过程中测量肝静脉压力梯度以估计门静脉压力。9例患者（56.2%）经组织学证实为VOD。VOD患者中75%存在胆囊壁增厚，而无VOD的患者均无此表现（P = 0.01）。胆囊壁增厚和腹水仅见于门静脉高压患者。9例患者（5例有VOD，4例无VOD）也接受了双功多普勒超声检查，门静脉和肝静脉未检测到明显的血流异常。这些结果表明，超声检查有助于发现门静脉高压的早期征象，从而有助于诊断骨髓移植患者的VOD。
