【作者】 徐茳蕾； 赵璇； 张倩； 陈文琪； 刘村；

【Author】 Xu jianglei;Zhao Xuan;Zhang Qian;Chen Wenqi;Liu Cun;Jinan Central Hospital;

【机构】 济南市中心医院超声科；

【摘要】 目的超声造影剂声诺维(SonoVue)应用于超声引导下经皮肝穿刺胆道引流(percutaneous transhepatic cholangial drainage,PTCD)中,观察引流管位置、超声造影剂在肝内胆管中的弥散情况及注射通畅度,以探讨超声造影在超声引导下经皮肝穿刺胆道引流后确定引流管位置及引流是否通畅的临床应用价值。方法选取2018年8月-2019年9月因胆系疾病在济南市中心医院住院患者47例,术前应用彩色多普勒超声观察胆系扩张情况,选定穿刺点。在超声引导下行经皮肝穿刺胆道引流术,术后经引流管注射稀释后造影剂,观察引流管位置、引流通畅度、肝内胆管显影情况。结果 47例经皮肝穿刺胆道引流,其中39例穿刺引流后造影可见引流管清晰显影,引流管头端置于理想位置,肝内胆管依次可见显影,造影剂弥散效果好。8例穿刺术后注射造影剂可见引流管显影,引流管头端未在预定位置,未见肝内胆管显影,调整引流管位置后再次进行超声造影,可见肝内胆管显影。结论超声引导下经皮肝穿刺胆道引流后,经引流管注射超声造影剂Sonovue,引流管位置、造影剂流动方向、肝内胆管均可清晰显示,对于判断引流管位置及引流是否通畅,具有较好的临床应用价值。同时对于广泛肝内胆管扩张患者,可根据造影情况决定是否进行另一侧胆管置管引流,对治疗有指导作用。更多还原

【Abstract】 Objective Ultrasound contrast agent(SonoVue) used in percutaneous transhepatic cholangial drainage,observation of drainage tube position,ultrasound contrast agent,diffuse in the intrahepatic bile ducts and the degree of injection flow,in order to investigate ultrasound imaging in ultrasound guided percutaneous liver biopsy to determine whether the position and the drainage tube drainage after biliary drainage unblocked clinical application value.Methods From August 2018 to September 2019,47 patients who were admitted to Jinan Central Hospital due to biliary tract disease were selected.Color doppler ultrasound was applied to observe biliary tract dilatation before surgery,and puncture sites were selected.Under the guidance of ultrasound,percutaneous hepatocentesis and biliary drainage were performed.After the operation,diluted contrast agent was injected through the drainage tube to observe the position of the drainage tube,the degree of drainage unobstruction and the intrahepatic bile duct development.Results Among 47 cases of percutaneous,hepatocentesis and drainage of biliary tract,39 cases showed clear development of drainage tube after puncture and drainage,the head of drainage tube was placed in an ideal position,the intrahepatic bile duct showed development in turn,and the diffusion effect of contrast agent was good.Intrahepatic bile duct development was observed in 8 patients after puncture injection of contrast agent,but the end of the drainage tube was not in the predetermined position,and intrahepatic bile duct development was not observed.Ceus was performed again after adjusting the position of the drainage tube,and intrahepatic bile duct development was observed.Conclusion After ultrasound-guided percutaneous hepatic puncture and drainage of the biliary tract,Sonovue was injected through the drainage tube,and the position of the drainage tube,the flow direction of the contrast agent and the intrahepatic bile duct could be clearly displayed,which has a good clinical value in judging the position of the drainage tube and whether the drainage is smooth or not.At the same time,for patients with extensive intrahepatic bile duct dilatation,the other side of the bile duct drainage can be determined according to the angiography,which has a guiding role in the treatment.更多还原