目的

探讨彩色多普勒超声（CDU）和超声造影（CEUS）在检测肝移植术后血管并发症中的应用价值并对两者进行比较。

方法

对肝移植术后患者常规行CDU检查，对CDU疑肝血管血流异常患者行超声造影检查，观察肝动脉、门静脉、下腔静脉及肝实质的血流灌注，对其中29例经数字减影血管造影术（DSA）或CT血管造影（CTA）/MR血管造影（MRA）证实病例的CDU及造影检查资料进行分析。

结果

术后血管并发症患者29例，其中肝动脉狭窄22例，肝动脉血栓闭塞3例（肝动脉血栓闭塞合并肝梗死2例），门静脉狭窄2例，下腔静脉狭窄1例，另1例为肝门部血肿并肝动脉、门静脉受压狭窄。CDU显示25例狭窄均有血流参数异常，但不能判断狭窄部位及程度，3例血栓闭塞者，动脉血流均未显示，但不能肯定诊断；超声造影可明确诊断肝动脉血栓闭塞，显示肝动脉、门静脉及下腔静脉狭窄，与DSA或CTA/MRA结果符合率分别为100%（3/3）、90.9%(20/22)、100%（2/2）及100%（1/1）。

结论

CDU与超声造影互为补充，有利于提高肝移植术后血管并发症的诊断准确性。

Objective

To evaluate and compare the value of color Doppler ultrasound(CDU)with contrast-enhanced ultrasound (CEUS) in detecting vascular complications after liver transplantation.

Methods

CDU was used as routine examination in all patients after liver transplantation.The liver transplantation recipients suspected by CDU with vascular complications underwent CEUS. Hepatic artery, portal vein, inferior vena cava and perfusion of liver parenchyma were observed. Twenty-nine patients who were confirmed by CT angiography(CTA)or digital subtraction angiography(DSA)or magnetic resonance angiography(MRA)were analyzed.

Results

There were 28 patients with vascular complications,including 22 with hepatic artery stenosis(HAS),3 with hepatic artery thrombosis(HAT),2 with portal vein stenosis(PVS)and 1 with inferior vena cava stenosis(IVCS).Vascular parameters of 25 patients with HAS were abnormal with sensitivity of 100%,but CDU could not show the stenosis position and degree.CDU did not demonstrate flow signal in 3 patients with HAT,but could not make a definite diagnosis.CEUS could confirmed not only HAT,but also diagnosed HAS,PVS and IVCS.The accordance rates for HAT,HAS,PVS and IVCS detected by CEUS compared to DSA and/or CTA and/or MRA were 100%(3/3),90.9%(20/22)，100%(2/2)and 100%(1/1).

Conclusion

CDU complements CEUS mutually,which may improve the diagnostic accuracy of vascular complications after liver transplantation.