摘要
目的评价多模态影像技术(彩色多普勒、超声造影、CTA、MRCP、DSA)在诊断和治疗肝移植术后急性肝动脉闭塞(HAO)的作用。方法对5例肝移植术后急性HAO病例的诊断和介入治疗过程进行回顾性分析。结果5例肝移植术后急性HAO病例均由彩色多普勒超声首先提示未见肝动脉血流信号及频谱,超声造影和增强CT亦未见肝动脉增强,5例全部经DSA确诊为HAO。5例患者在经导管给予持续小剂量溶栓治疗后,再次行血管造影检查,肝动脉完全开通,其中3例进行了血管内支架植入治疗。6~16个月后随访,4例患者肝功能指标完全恢复正常,1例患者肝功能指标逐步接近正常,肝实质均未见坏死,但其中4例出现胆道并发症,3例患者胆管壁超声造影提示血供差。结论多模态影像技术对肝移植术后急性HAO的诊断、治疗及预后评估具有重要价值,经导管持续小剂量溶栓治疗是处理肝移植术后急性HAO的有效方法。
Objective To evaluate the value of multimodal imaging techniques(color Doppler,contrast-enhanced ultrasound,CTA,MRCP,DSA)in the diagnosis and treatment of acute hepatic artery occlusion(HAO)after liver transplantation.Methods Retrospective analysis was made on the diagnosis and treatment process of 5 cases of acute HAO after liver transplantation.Results All the 5 cases of acute HAO after liver transplantation were confirmed by DSA after ultrasonography,contrast-enhanced ultrasonography(CEUS)and CTA.,which indicated that there was no hepatic artery blood flow signal,After receiving continuous low dose thrombolytic therapy through catheter,5 patients underwent angiography again,and the hepatic artery was completely opened.Three patients underwent endovascular stent implantation.After 6-16 months of follow-up,liver function indexes of 4 patients completely returned to normal,1 patient gradually approached normal,liver parenchymal necrosis was not observed,but biliary complications occurred in 4 patients,and poor blood supply in bile duct wall was indicated by contrast-enhanced ultrasound in 3 patients.Conclusion Multimodal imaging technique is of great value in the diagnosis,treatment and prognosis evaluation of acute HAO after liver transplantation.Continuously low-dose transcatheter thrombolysis is an effective method for the management of acute HAO after liver transplantation.
作者
赵宁波
张瑜
苏瑞
冯凯
曹义
姜楠
董常峰
ZHAO Ning-bo;ZHANG Yu;SU Rui;FENG Kai;CAO Yi;JIANG Nan;DONG Chang-feng(Department of Ultrasound,The Third People's Hospital of Shenzhen,Shenzhen 518112,Guangdong Province,China;Department of Radiology,The Third People's Hospital of Shenzhen,Shenzhen 518112,Guangdong Province,China;Department of Liver Surgery,The Third People's Hospital of Shenzhen,Shenzhen 518112,Guangdong Province,China)
出处
《罕少疾病杂志》
2021年第3期62-66,共5页
Journal of Rare and Uncommon Diseases
基金
国家自然科学基金项目(81570552)
深圳市医学重点学科建设经费资助(No.SZXK079)。
关键词
多模态影像技术
肝移植
肝动脉闭塞
Multimodal image technology
Liver transplantation
Hepatic artery occlusion
