声触诊组织量化技术评估经颈静脉肝内门体分流术联合胃冠状静脉栓塞术疗效

发布时间：2018-05-03 22:44

本文选题：经颈静脉肝内门体分流术 + 胃冠状静脉栓塞术　；参考：《中国医学影像技术》2015年06期

【摘要】：目的探讨应用声触诊组织量化(VTQ)技术测量脾脏剪切波速度(SSWV)无创评价经颈静脉肝内门体分流术(TIPS)联合胃冠状静脉栓塞术(GCVE)疗效的价值。方法将19例接受TIPS联合GCVE治疗的肝硬化门静脉高压患者分为A(13例,接受1次治疗)、B(6例,首次治疗后因支架闭塞再次接受治疗)两组。应用VTQ技术分别与治疗前1天、治疗后6天测量SSWV,以脉冲波多普勒测量门静脉主干血流速度(PVV)、脾静脉主干血流速度(SVV)。于TIPS联合GCVE治疗过程中,以直接测压法测量支架植入前及植入后的门静脉压(PPG),并进行统计分析。结果 TIPS联合GCVE治疗后,A、B两组PPG均较治疗前明显减低(P均0.05);SSWV均较治疗前明显减低,PVV、SVV均较治疗前明显升高(P均0.05)。A、B两组治疗前及治疗后SSWV均与PPG呈正相关(P均0.05),PVV、SVV均与PPG无相关性(P均0.05)。结论应用VTQ技术所测SSWV与PPG存在相关性,可作为TIPS联合GCVE治疗前后监测门静脉压力的无创定量评估指标。
[Abstract]:Objective to evaluate the noninvasive evaluation of splenic shear wave velocity (SSWV) by acoustic palpation tissue quantification (VTQ) technique in evaluating the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with gastric coronary vein embolization (GCVEV). Methods Nineteen patients with portal hypertension of cirrhosis treated with TIPS and GCVE were divided into two groups: 13 patients with portal hypertension treated with Agnus, 6 patients with BX treated once, and treated again after the first treatment because of stent occlusion. The blood flow velocities of portal vein and splenic vein were measured by pulse wave Doppler and splenic vein blood flow velocity respectively 1 day before treatment and 6 days after treatment. In the course of TIPS combined with GCVE, the portal vein pressure before and after stent implantation was measured by direct manometry, and the statistical analysis was carried out. Results after TIPS and GCVE treatment, PPG in both groups were significantly lower than those before treatment (P < 0.05). Both groups were significantly lower than those before and after treatment. The levels of SSWV in both groups were significantly higher than those before and after treatment (P = 0.05), and there was a positive correlation between SSWV and PPG in both groups (P = 0.05). PPG had no correlation (P < 0.05). Conclusion SSWV measured by VTQ is correlated with PPG and can be used as a noninvasive quantitative evaluation index for monitoring portal vein pressure before and after treatment with TIPS combined with GCVE.
【作者单位】：重庆医科大学超声影像学研究所;重庆市渝中区疾病预防控制中心传染病防治科;重庆医科大学附属第二医院感染科;重庆医科大学附属第二医院消化内科;
【基金】：国家自然科学基金(81271598;81270021) 重庆市杰出青年基金(cstc2013jcyjjq10004) 教育部科学技术研究重点项目([2012]76) 重庆市教委科学技术研究重点项目(KJ120328)
【分类号】：R445.1;R575.2

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