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The evaluation of observing acute rejection after orthotopic liver transplantation by color Doppler image
Zou Ruhai, Li Anhua, Han Feng, Pei Xiaoqing, Zhou Jianhua, Huang Jun, Chen Xiaoyue<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
Sun Ye-san university affiliated tumor hospital, Ultrasound department
Abstract
Objective: To study the changes of hepatic morphologic, hemodynamics and acute rejection in patients with orthotopic liver transplantation (OLT) by color Doppler imaging (CDI)
Methods: The hepatic artery velocity (HA-V), resistance index (HA-RI), acceleration (ACC), acceleration time (AT), portal vein velocity (PV-V) were measured by CDI.The hepatic vein waveform was described.
Results: 1case with acute rejection was diagnosed by CDI and biopsy. There are typical characteristic of acute rejection in his hepatic vein waveform.
Conclusions: CDI is a good method to discover and follow up the acute rejection of OLT.
Key Words: Color Doppler image orthotopic liver transplantation acute rejection
原位肝移植术（Orthotopic liver transplantation, OLT）是终末期肝疾病最后可能的治疗方法[1]。彩色多普勒超声（Color Doppler Image, CDI）因其具有灵活、无创伤性、实时动态观察等特点成为一种适合于观察肝移植前后肝脏血流动力学的方法[1]。我科对2003年10月到2004年7月间在我院行肝移植手术的16例肝癌病人进行常规彩色多普勒超声检查。本文主要探讨CDI在肝移植术后急性排斥反应中的作用及意义。
资料与方法
一般资料 我院2003年10月～2004年7月进行原位肝移植术的病人16例，患者年龄24～62岁，男性15例，女性1例，均因原发性肝癌反复治疗无效者。术前行彩色多普勒超声检查。16例均采用改良背驮式原位肝移植术。
检查方法 彩色多普勒超声检查使用百胜（ESAOTE）DU8及泰胜2000便携式彩色超声仪。术后第12小时内作彩色多普勒超声检查一次，术后第2、3、5、7、9、11、15、21天各作彩色多普勒超声检查一次，三周内共做9次检查；患者出院后每周复查一次，遇异常情况增加检查频率。观察肝脏形态、大小、实质回声、肝脏周围有无异常；观察肝脏肝固有动脉、门静脉、肝静脉、下腔静脉及他们的分支，并作频谱分析；观察肝内外胆管情况。必要时行超声引导下细针肝穿刺活检及动脉造影。 | 
