| 吴晓冬,刘松,王峰,张勇,蔡金贞,王建红.经T管超声胆管造影评估肝移植术后早期肝内外胆管[J].中国医学影像技术,2022,38(8):1203~1207 |
| 经T管超声胆管造影评估肝移植术后早期肝内外胆管 |
| T-tube contrast-enhanced ultrasonic cholangiography for early evaluation of intrahepatic and extrahepatic bile ducts after liver transplantation |
| 投稿时间：2021-11-08 修订日期：2022-04-20 |
| DOI：10.13929/j.issn.1003-3289.2022.08.018 |
| 中文关键词: 肝移植 胆管造影 超声检查 并发症 T管 |
| 英文关键词:liver transplantation cholangiography ultrasonography complications T-tube |
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| 中文摘要: |
| 目的 探讨以经T管超声胆管造影(CEUSC)评估肝移植术后早期肝内外胆管的可行性。方法 纳入17例接受肝移植患者,均于术后早期(中位时间28天)因血清学检查异常接受经T管二维、三维CEUSC及X线胆管造影检查;对比3种方法显示肝外胆管(尤其是吻合口区域),左、右叶肝内胆管及其不同级别分支的能力。结果 17例中,3例发生胆道并发症,包括T管脱出2例、胆管结石1例。二维、三维CEUSC均可清晰显示并明确诊断;X线胆管造影仅显示2例T管脱出,未显示胆管结石。除2例因T管脱出未能显示肝内外胆管外,3种检查对其余15例均能完整显示肝外胆管及1、2级肝内胆管,符合诊断要求。3种检查方法所示肝右叶最远端胆管级别均高于肝左叶(P均＜0.05),其间差异无统计学意义(P＞0.05)。3种方法对1~4级肝内胆管评分差异均无统计学意义(P均＞0.05),对5级肝内胆管评分差异有统计学意义(P＜0.01),其中二维CEUSC评分高于X线胆管造影和三维CEUSC (P均＜0.05)、X线胆管造影与三维CEUSC差异无统计学意义(P＞0.05)。结论 经T管CEUSC可于肝移植术后早期显示肝内外胆管,辅助诊断胆道并发症。 |
| 英文摘要: |
| Objective To investigate the feasibility of T-tube contrast-enhanced ultrasonic cholangiography (CEUSC) for early evaluation of intrahepatic and extrahepatic bile ducts after liver transplantation. Methods Totally 17 patients after liver transplantation underwent T-tube 2D, 3D CEUSC and X-ray cholangiography due to serological abnormalities in the early postoperative period (median time 28 days). The extrahepatic bile ducts (especially the anastomotic area), the most distant grade of intrahepatic bile ducts in the left and right liver lobe, and the ability for displaying different grade bile ducts were compared among the above 3 examination methods. Results Among 17 patients, biliary tract complications occurred in 3 cases, including 2 cases of T-tube prolapse and 1 case of biliary stone. Both 2D and 3D CEUSC clearly showed complications in all 3 cases, while X-ray cholangiography only showed T-tube prolapse but failed to show biliary stone. Except for the above 2 cases of T-duct prostration, common hepatic duct and 1-2 grade bile ducts were depicted with all 3 examinations 15 cases, which met the diagnostic requirements. The most distant grade of intrahepatic bile ducts in the liver right lobe were higher than that in the liver left lobe (all P<0.05), there was no significant difference among 3 methods (P>0.05). There was no significant difference of scoring of grade 1-4 intrahepatic ducts among 3 examination methods (all P>0.05). Significant difference was found for scoring of grade 5 intrahepatic bile duct among 3 examination methods (P<0.01), the scores of 2D CEUSC were higher than that of the other 2 methods (both P<0.05), but no significant difference was detected between 3D CEUSC and X-ray cholangiography (P>0.05). Conclusion T-tube CEUSC could be used to display intrahepatic bile ducts in early stage after liver transplantation for assisting diagnosis of some biliary complications. |
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