Kok T, Peeters P M, Hew J M, Martijn A, Koetse H A, Bijleveld C M, Slooff M J
Department of Diagnostic Radiology, University Hospital Groningen, The Netherlands.
Pediatr Radiol. 1995;25(7):517-24. doi: 10.1007/BF02015783.
Despite the availability of Doppler ultrasound, angiography still forms part of the protocol for evaluating children after orthotopic liver transplantation (OLT) at our department. To investigate whether Doppler ultrasound is a reliable method for evaluating the patency of the hepatic artery, portal vein, inferior vena cava, and the anastomotic site of the portal vein in children after OLT, we performed a prospective study in which Doppler ultrasound was compared with angiography in 38 children with 40 transplants (ten examinations on clinical demand and 49 examinations according to protocol). Good correlation was found in relation to demonstrating a patent hepatic artery (sensitivity 96% and specificity 100%). Two false-negative Doppler ultrasound results were attributable to technical difficulties and rejection. For evaluating the patency of the portal vein, Doppler ultrasound agreed with angiography in 58 of the 59 examinations (98%). The one and only false-positive angiography result was explained by inadequate opacification. Doppler ultrasound visualized stenosis of the portal vein three times more often than angiography. In seven children, Doppler ultrasound findings suspicious of pathology of the inferior vena cava were confirmed using cavography or surgery. Doppler ultrasound proved to be a reliable technique for evaluating the patency of the hepatic artery, inferior vena cava, and portal vein and the anastomotic site of the portal vein.
尽管有多普勒超声可用，但血管造影术仍是我们科室对原位肝移植（OLT）术后儿童进行评估方案的一部分。为了研究多普勒超声是否是评估OLT术后儿童肝动脉、门静脉、下腔静脉及门静脉吻合口通畅情况的可靠方法，我们进行了一项前瞻性研究，将38例接受40次移植手术的儿童（10次根据临床需求检查，49次按方案检查）的多普勒超声检查结果与血管造影结果进行比较。在显示肝动脉通畅方面发现了良好的相关性（敏感性96%，特异性100%）。2例假阴性的多普勒超声结果归因于技术困难和排斥反应。在评估门静脉通畅情况时，59次检查中有58次（98%）多普勒超声检查结果与血管造影结果一致。唯一的1例假阳性血管造影结果是由于造影剂充盈不足所致。多普勒超声显示门静脉狭窄的次数是血管造影的3倍。在7例儿童中，通过腔静脉造影或手术证实了多普勒超声对下腔静脉病变的可疑发现。多普勒超声被证明是评估肝动脉、下腔静脉、门静脉及门静脉吻合口通畅情况的可靠技术。
