|本期目录/Table of Contents|

[1]金伟奎,黄艳丽,韩浩,等.超声和剪切波弹性成像对经颈静脉肝内门体静脉分流术后支架功能障碍的价值[J].医学研究与战创伤救治(原医学研究生学报),2021,23(05):466-470.[doi:10.3969/j.issn.1672-271X.2021.05.004]
　JIN Wei-kui,HUANG Yan-li,HAN Hao,et al.Value of ultrasound and shear wave elastography in stenting dysfunction after transjugular intrahepatic portosystemic shunt[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2021,23(05):466-470.[doi:10.3969/j.issn.1672-271X.2021.05.004]
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超声和剪切波弹性成像对经颈静脉肝内门体静脉分流术后支架功能障碍的价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第23卷
期数:
2021年05
页码:
466-470
栏目:
临床研究
出版日期:
2021-09-20

文章信息/Info

Title:
Value of ultrasound and shear wave elastography in stenting dysfunction after transjugular intrahepatic portosystemic shunt
作者:
金伟奎; 黄艳丽; 韩浩; 杨建; 诸葛宇征; 孔文韬; 吴敏
作者单位：210008南京，南京大学医学院附属南京鼓楼医院超声诊断科（金伟奎、韩浩、杨建、孔文韬、吴敏），消化内科（诸葛宇征）；210002南京，东部战区总医院秦淮医疗区特诊科（黄艳丽）
Author(s):
JIN Wei-kui1;  HUANG Yan-li2;  HAN Hao1;  YANG Jian1;  ZHUGE Yu-zheng3;  KONG Wen-tao1;  WU Min1
（1.Department of Ultrasound, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China；2.Department of Special Diagnosis，Qinhuai Medical District, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China；3.Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School，Nanjing 210008, Jiangsu, China）
关键词:
超声; 剪切波弹性成像; 经颈静脉肝内门体分流术; 支架功能障碍; 门静脉高压
Keywords:
ultrasound;  shear wave elastography;  transjugular intrahepatic portosystemic shunt;  stent dysfunction; portal hypertension
分类号:
R445.14R322.123R446.114
DOI:
10.3969/j.issn.1672-271X.2021.05.004
文献标志码:
A
摘要:
目的探讨超声和剪切波弹性成像（SWE）对肝硬化门静脉高压症患者经颈静脉肝内门体静脉分流术（TIPS）后支架功能障碍的价值。方法回顾性分析2015年10月至2017年8月在南京鼓楼医院行TIPS治疗的肝硬化门脉高压患者的临床资料，术后行超声及SWE技术规律随访，经数字减影血管造影（DSA）证实支架功能障碍者26例次。常规超声测量支架内流速、门静脉和脾静脉内径及流速；采用SWE技术测量肝、脾剪切波速度（SWV）。结果与TIPS支架通畅时相比，支架功能障碍时，门静脉流速[（55.30±8.60) cm/s vs (33.54±6.09）cm/s]、脾静脉流速[（47.10±6.54)cm/s vs （32.18±4.72）cm/s]下降，脾SWV值[（2.99±0.22) m/s vs (3.31±0.24）m/s]上升，差异有统计学意义（P<0.001）。与功能障碍时相比，支架再通术后门静脉流速[（33.54±6.09) cm/s vs (47.40±5.70）cm/s]、脾静脉流速[（32.18±4.72) cm/s vs (47.74±5.25）cm/s]上升，脾SWV值[（3.31±0.24) m/s vs (2.83±0.20）m/s]下降，差异有统计学意义（P<0.001）。支架通畅时与功能障碍时进一步相比，门静脉、脾静脉流速及脾SWV值的变化差值AUC曲线下面积分别为0.969、0.967、0.892,差异无统计学意义(P>0.05)。结论门静脉流速、脾静脉流速及脾SWV值可用于肝硬化门脉高压症患者TIPS术后支架功能障碍的诊断，具有较好的诊断效能。
Abstract:
ObjectiveTo explore the value of ultrasound and shear wave elastography in stenting dysfunction after intrahepatic portal vein shunt（TIPS） in patients with cirrhosis portal hypertension.MethodsThe clinical data of cirrhotic patients with portal hypertension treated by TIPS in Nanjing Drum Tower Hospital from October 2015 to August 2017 were retrospectively analyzed.With following up regularly ultrasound and shear wave elastography (SWE) after TIPS, 26 patients with stent dysfunction were confirmed by digital subtraction angiography（DSA）. Routine ultrasound was used to measure the internal velocity of the stent, the inner diameter and velocity of the portal vein and splenic vein. SWE technique was used to measure the shear wave velocity (SWV) of liver and spleen.ResultsIn patients with stent dysfunction, compared with patients with stent patency, portal vein velocity [(55.30±8.60) cm/s vs (33.54±6.09) cm/s], splenic vein velocity [(47.10±6.54) cm/s vs (32.18±4.72) cm/s] decreased, and spleen SWV value [(2.99±0.22) m/s vs (3.31±0.24) m/s] were increased (P<0.001). After stent recanalization compared with dysfunction, portal vein flow rate [(33.54±6.09) cm/s vs (47.40±5.70) cm/s], splenic vein flow rate [(32.18±4.72) cm/s vs (47.74±5.25) cm/s] were increased, and spleen SWV value [(3.31±0.24) m/s vs (2.83±0.20) m/s] was decreased (P<0.001). Further comparison between stent patency and dysfunction showed that the area under AUC curve of portal vein flow rate, splenic vein flow rate and SWV value of spleen were 0.969, 0.967 and 0.892, respectively (P>0.05).ConclusionPortal vein velocity, splenic vein velocity and spleen SWV value can be used for the diagnosis of stent dysfunction in patients with cirrhosis portal hypertension after TIPS, with good diagnostic efficacy.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81671701）
更新日期/Last Update: 2021-10-11