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Objective: To investigate the color Doppler ultrasound diagnosis of primary biliary cirrhosis (primary biliary cirrhosis, PBC) the clinical value. MATERIALS AND METHODS: An object of study: 40 cases of normal control group (A group), select the age, gender and experimental group matched healthy volunteers, 40 patients (history, physical examination, laboratory tests including liver function tests were normal immune) 4 males and 36 females, aged 23 to 75 years, average age 41.7 ± 13.8 years old. Experimental group: 49 cases, according to the the liver histopathology staging situation, divided into 2 groups. Early group (B): a clinical diagnosis of primary biliary cirrhosis, liver histopathology I (5 cases) and II (n = 12), a total of 17 cases, 2 males and 15 females, aged 25 to 59 years, average age 37.9 ± 17.2 years old. Late group (C group): a clinical diagnosis of primary biliary cirrhosis, liver histopathology of III (18 cases) and Phase IV (n = 14), a total of 32 cases, 3 males and 29 females, aged from 31 to 71 years, average age 50.2 ± 14.8 years old. 2 Check METHODS: The United States GE Logiq 9 the Philips the iU22 color Doppler ultrasonic diagnostic apparatus, the probe frequency is 2 to 5 MHz. The biopsy device is in the United States Bard biopsy gun with the corresponding 16G within the groove cutting biopsy needle. Subjects lateral position, first made two-dimensional ultrasound (2D U.S.) scanning, to observe the structure of the liver and the real echo, blood vessels in the liver, bile duct. Color Doppler flow imaging (CDFI) to observe the liver blood vessels (hepatic artery, portal vein, hepatic vein) hemodynamic characteristics, and collect information on the research data. The test group patients line ultrasound-guided percutaneous liver biopsy tissue pathological diagnosis, and are used for grouping. 3 Statistical analysis: All statistical processing of the application SPSS13.0 statistical software. A, B, C group liver morphology, size, internal structure, liver vascular hemodynamic changes in the measured values ??are expressed as mean ± standard deviation (x ± s), groups were compared using analysis of variance. All statistical tests, P values ??are set to less than 0.05 was considered statistically significant. Results: 149 patients with primary biliary cirrhosis liver pathology staging distribution: Phase I (bile duct inflammation) 5 cases, Phase II (bile duct hyperplasia of) 12 cases of III (fibrosis stage), 18 cases Phase IV (liver cirrhosis) in 14 cases. Among the early group (Ⅰ, Ⅱ) in 17 cases, accounting for 34.7%, while the late group (III, IV) 32 cases, 65.3%. 2 different pathological stage primary biliary cirrhosis (PBC) performance of the two-dimensional ultrasound: liver morphology, size, intrahepatic structure, hepatic parenchymal echo with the severity of disease, with the severity of the lesion and development. Early in the PBC, performance increased liver, liver parenchymal echo was slightly thicker or fine kind of slightly stronger echo nodules is not obvious. PBC late part of the development of portal hypertension. Color Doppler flow imaging features 3 different pathological stage primary biliary cirrhosis (PBC): 3.1 vein (Portal vein PV) early group: portal vein diameter than the normal group widened, but the difference was not statistically significance (P gt; 0.05). Slightly reduce the average velocity of the portal vein in the early group, blood flow increased slightly, with the normal group, the difference was not statistically significant (P GT; 0.05), portal vein velocity curve shape of smooth continuity. Late group: portal vein diameter was significantly widened, with the normal group, the early group, the difference was statistically significant (P lt; 0.05). The average velocity of the portal vein significantly reduced blood flow increased significantly, with the normal group, the early group, the difference was statistically significant (P lt; 0.05), portal vein velocity curve straight continuity. 3.2 hepatic artery (the Hepatic artery HA): early group: the inner diameter of the hepatic artery widened compared with the normal group, but the difference was not statistically significant (P gt; 0.05) Hepatic artery peak systolic velocity, resistance index of the hepatic artery, blood flow than the normal group, the difference was not statistically significant (P gt; 0.05) Late group: the inner diameter of the hepatic artery significantly wider than the normal group, the difference was statistically significant (P lt; 0.05) Hepatic artery peak systolic velocity, resistance index of the hepatic artery, blood flow increased significantly, with the normal group, the early group, the difference was statistically significant (P lt; 0.05) 3.3 hepatic vein (hepatic veins, HV) early group: the inner diameter of the hepatic vein than the normal group thinner, but the difference was not statistically significant (P gt; 0.05) Vein maximum flow rate of blood flow in the liver than in normal group reduced the difference was not statistically significant (P gt; 0.05) Late group: the inner diameter of the vein in the liver than in normal group was significantly thinner, the difference was statistically significant (P lt; 0.05). Hepatic vein to increase the flow rate, a significant reduction in blood flow, with the normal group, the early group, the difference was statistically significant (P lt; 0.05) Conclusion: PBC-dimensional ultrasound imaging to visual cues of primary biliary cirrhosis liver damage to the substance of the case, but the two-dimensional ultrasound is not specific. PBC color Doppler ultrasound imaging with the severity of lesions, hepatic artery, portal vein, hepatic vein diameter, flow rate, spectrum has a corresponding change. PBC disease development as well as pathological staging of liver tissue consistent with the results, color Doppler ultrasound imaging can be a good evaluation of hemodynamic changes of the liver, impaired liver function diagnosis and staging evaluation to help. The joint use of two-dimensional ultrasound imaging and color Doppler flow imaging is of great significance for clinical diagnosis and prognosis of patients with PBC. 3 ultrasound-guided liver biopsy liver pathology diagnosis of PBC and installment basis at primary biliary cirrhosis diagnosis and staging of the gold standard.
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