COLOR DOPPLER IMAGING OF PORTOSYSTEMIC SHUNTS
COLOR DOPPLER IMAGING OF PORTOSYSTEMIC SHUNTS
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DOI：
10.2214/ajr.154.2.2105035
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发表时间：
1990-02-01
影响因子：
5
通讯作者：
BUSUTTIL, RW
中科院分区：
文献类型：
--
作者：
GRANT, EG;TESSLER, FN;BUSUTTIL, RW
本研究旨在探讨彩色多普勒超声在评估门静脉系统分流中的应用。31例患者共32条分流线进行了影像学检查。所检查的分流类型包括门静脉，5个；mesocaval, 8;远端脾肾（Warren）， 14；中心房，5个。在不知道分流器状态的情况下进行超声检查，尽管分流器的类型在研究开始前是已知的。在与血管造影或磁共振成像（22例）进行前瞻性比较的基础上，对超声研究进行评估，以确定其敏感性和特异性。彩色多普勒比双多普勒超声在评估门静脉系统分流的可能优势也进行了研究，彩色多普勒超声对分流吻合口的特异性成像能力也进行了研究。彩色多普勒超声在22例可获得相关成像的分流管中成功推断分流管通畅（17例）或血栓形成（5例）（敏感性100%，特异性100%）。在对所有32个分流的双工超声和彩色多普勒超声进行比较时，两种技术在门静脉、中腔静脉和心房中系静脉分流中建立通畅几乎同样有效。然而，双多普勒超声在14例脾肾分流中仅提供了4例有用的诊断信息。彩色多普勒正确推断所有14例通畅或血栓形成。在所有32例分流术中，23例彩色多普勒显示吻合清晰，可能有4例，5例完全没有吻合。我们的结果表明，彩色多普勒超声是一个很好的方法来评估各种手术创建的门静脉系统分流。特别是，彩色多普勒超声在脾肾通讯成像方面似乎优于双多普勒超声。
This study was designed to investigate the utility of color Doppler sonography in the evaluation of portosystemic shunts. Thirty-one patients with a total of 32 shunts were imaged. The types of shunts examined included portacaval, five; mesocaval, eight; distal splenorenal (Warren), 14; and mesoatrial, five. Sonography was performed without knowledge of the status of the shunt, although the type of shunt was known before beginning the study. The sonographic studies were evaluated to determine their sensitivity and specificity on the basis of a prospective comparison with angiography or MR imaging (22 cases). The possible advantages of color Doppler over duplex Doppler sonography in evaluating portosystemic shunts were also investigated, as was the ability of color Doppler sonography to image specifically the shunt anastomoses. Color Doppler sonography successfully inferred shunt patency (17 cases) or thrombosis (five cases) in all 22 shunts for which correlative imaging was available (sensitivity = 100%, specificity = 100%). In comparing duplex with color Doppler sonography in all 32 shunts, the two techniques were almost equally effective in establishing patency in portacaval, mesocaval, and mesoatrial shunts. Duplex Doppler sonography, however, provided useful diagnostic information in only four of 14 splenorenal shunts. Color Doppler correctly inferred patency or thrombosis in all 14. Among all 32 shunts, the anastomosis was shown clearly by color Doppler in 23, probably in four, and not at all in five. Our results suggest that color Doppler sonography is an excellent method for the evaluation of all varieties of surgically created portosystemic shunts. In particular, color Doppler sonography appears to be superior to duplex Doppler sonography in imaging splenorenal communications.