肝脾二维剪切波弹性成像预测经颈静脉肝内门体分流术后早期分流道功能障碍
Two-Dimensional Shear Wave Elastography of Liver and Spleen in Predicting Early Shunt Dysfunction After Transjugular Intrahepatic Portosystemic Shunt
邱文倩 1张超学1
作者信息
- 1. 安徽医科大学第一附属医院超声科,安徽 合肥 230022
- 折叠
摘要
目的 探讨经颈静脉肝内门体分流术后二维剪切波弹性成像(SWE)监测肝脏硬度及脾脏硬度(S-SWE)变化对于预测支架功能障碍的价值.资料与方法 回顾性选取 2016 年 1 月—2022 年 9 月于安徽医科大学第一附属医院行经颈静脉肝内门体分流术的乙型病毒性肝炎肝硬化患者 40例,将术后 1个月内未发生功能障碍的 22例纳入支架通畅组,术后 1周未发生、术后1个月发生功能障碍的18例纳入支架功能障碍组.监测术前1 d、术后1周、术后1个月肝脏硬度及S-SWE变化规律.结果 Mauchly检验显示数据符合球形分布(P>0.05).两组患者组内术前、术后肝脏硬度差异均无统计学意义(F 时间=0.003,F 时间×分组=0.842,F 组间=0.027;P均>0.05),S-SWE差异均有统计学意义(F 时间=51.249,F 时间×分组=30.676,F 组间=11.986;P均<0.01).进一步行事后两两比较,支架通畅组术前1 d、术后 1周、术后1 个月S-SWE呈逐渐下降趋势,差异有统计学意义(P<0.05);支架功能障碍组术后1周肝脏硬度较术前1 d下降(P<0.05),术后1个月肝脏硬度回升,与术前1 d差异无统计学意义(P>0.05).进一步比较两组S-SWE差值的绝对值(ΔS-SWE),ΔS-SWE(术后1个月-术后1周)、ΔS-SWE(术后1个月-术前1 d)差异有统计学意义(t=-2.612、4.368,P<0.05).结论 定量测量经颈静脉肝内门体分流术前后 S-SWE 并观察其变化趋势,有利于判断是否存在支架功能障碍、评价手术疗效.
Abstract
Purpose To explore the value of monitoring liver-shear wave elastography(L-SWE)and spleen-shear wave elastography(S-SWE)by two-dimensional shear wave elastography after transjugular intrahepatic portosystemic shunt(TIPS)in predicting stent dysfunction.Materials and Methods A total of 40 patients with hepatitis B cirrhosis in the First Affiliated Hospital of Anhui Medical University from January 2016 to September 2022 who underwent TIPS were retrospectively selected.Among them,22 patients without stent dysfunction within 1 month were included in the normal group,and 18 patients without stent dysfunction within 1 week but with stent dysfunction within 1 month were included in the dysfunction group.The changes of L-SWE and S-SWE were monitored 1 day before operation,1 week and 1 month after operation.Results Mauchly test showed that the data corresponded to sphericity(P>0.05).There was no significant difference in L-SWE within the two groups before and after operation(Ftime=0.003,Ftime×group=0.842,Fgrous=0.027;all P>0.05),while the S-SWE differences were statistically significant(Ftime=51.249,Ftime×group=30.676,Fgrous=11.986;all P<0.01).The S-SWE in the normal group showed a gradually decreasing trend 1 day before operation,1 week after operation and 1 month after operation,and the difference was statistically significant(P<0.05).The L-SWE in the dysfunction group decreased 1 week after operation compared with 1 day before operation(P<0.05),and the L-SWE increased 1 month after operation,with no significant difference compared with 1 day before operation(P>0.05).The difference of ΔS-SWE(1 month after operation-1 week after operation)and ΔS-SWE(1 month after operation-1 day before operation)was statistically significant(t=-2.612,4.368,P<0.05).Conclusion Quantitative measurement of S-SWE before and after TIPS and observation of its variation trend are helpful to estimate whether there is stent dysfunction and evaluate the surgical effect.
关键词
肝硬化/高血压,门静脉/门体分流术,经颈静脉肝内/剪切波弹性成像/脾脏硬度Key words
Cirrhosis/Hypertension,portal/Portosystemic shunt,transjugular intrahepatic/Shear wave elastography/Spleen-shear wave elastography引用本文复制引用
基金项目
安徽省重点研发计划(202004j07020031)
出版年
2024
NETL
NSTL
万方数据