常规超声与超声造影评估肝硬化门静脉高压症患者TIPS术后支架功能价值分析*

doi:10.3969/j.issn.1672-5069.2025.04.028

实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (4): 589-592.doi: 10.3969/j.issn.1672-5069.2025.04.028

常规超声与超声造影评估肝硬化门静脉高压症患者TIPS术后支架功能价值分析^*

高晓婷, 高鑫, 刘艳莉, 康旺旺, 王海婷

719000 陕西省榆林市西安交通大学第一附属医院榆林医院超声医学科(高晓婷,高鑫,刘艳莉,康旺旺);榆林市第一医院体检中心(王海婷)

收稿日期:2024-11-12 出版日期:2025-07-10 发布日期:2025-07-14
通讯作者: 王海婷,E-mail:18891529052@163.com
作者简介:高晓婷,女,36岁,医学硕士,主治医师。E-mail:18891529052@163.com
基金资助:
^*陕西省榆林市科技计划项目(编号:YF-2022-39)

Comparison of conventional ultrasonography and contrast-enhanced ultrasonography in assessing stent function in patients with cirrhotics with portal hypertension after TIPS treatment

Gao Xiaoting, Gao Xin, Liu Yanli, et al

Department of Ultrasound, Yulin Hospital, First Affiliated Hospital to Jiaotong University, Yulin 719000, Shaanxi Province, China

Received:2024-11-12 Online:2025-07-10 Published:2025-07-14

摘要/Abstract

摘要： 目的分析常规超声与超声造影(CEUS)评估肝硬化并发门静脉高压症患者经颈静脉肝内门体分流术(TIPS)术后支架功能的价值。方法 2021年11月～2024年10月我院收治的80例乙型肝炎肝硬化并发门静脉高压症患者,接受TIPS治疗。使用常规超声和CEUS检查,以数字减影血管造影(DSA)为判断的金标准,采用Kappa一致性检验,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)评估诊断效能。结果在术后6个月检查,DSA检查发现80例接受TIPS术的患者支架功能良好73例(91.3%),支架功能障碍7例(8.7%);常规超声发现支架功能障碍5例,CEUS检查发现6例;常规超声评估TIPS术后支架功能障碍的AUC为0.857(95%CI:0.761～0.925),其灵敏度(Se)、特异度(Sp)、准确率(Ac)、阳性预测值(PPV)和阴性预测值(NPV)分别为57.1%、98.6%、95.0%、80.0%和96.0%,而CEUS评估的AUC为0.929(95%CI:0.848～0.974),其Se、Sp、Ac、PPV和NPV分别为71.4%、98.6%、96.3%、83.3%和97.3%,两者诊断的一致性较好(Kappa>0.640)。结论使用常规超声检查能够满足评估肝硬化并发门静脉高压症患者TIPS术后支架功能,我们不建议常规进行CEUS检查。

关键词: 肝硬化, 门静脉高压症, 经颈静脉肝内门体分流术, 超声检查, 支架功能, 诊断

Abstract: Objective The aim of this study was to compare conventional ultrasonography and contrast-enhanced ultrasonography(CEUS) in assessing stent function in patients with cirrhotics with portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS) treatment. Methods 80 patients with hepatitis B-induced liver cirrhosis (LC) with PH were encountered in our hospital between November 2021 and October 2024, and all underwent TIPS routinely. Patients received digital subtraction angiography (DSA), conventional ultrasonography and CEUS examinations after surgery. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate diagnostic efficacy, and diagnostic consistency was assessed by Kappa analysis. Results By end of six months after TIPS, DSA found stent function normal in 73 cases(91.3%) and disabled stent function in 7 cases (8.7%) in the 80 patients with LC; conventional ultrasound found disabled stent function in 5 cases and CEUS found in 6 cases; the AUC was 0.857(95%CI:0.761-0.925)by conventional ultrasound in judging stent function disable, with sensitivity(Se), specificity(Sp), accuracy(Ac), positive predictive value (PPV) and negative predictive value (NPV) of 57.1%, 98.6%, 95.0%, 80.0% and 96.0%, and the AUC was 0.929(95%CI:0.848-0.974)by CEUS, with Se, Sp, Ac, PPV and NPV of 71.4%, 98.6%, 96.3%, 83.3% and 97.3%, respectively, with the consistence satisfactory (Kappa>0.640). Conclusion We recommend conventional ultrasonography for assessing stent function in patients with cirrhotic portal hypertension after TIPS, and CEUS could be done unless necessary.

Key words: Liver cirrhosis, Portal hypertension, Transjugular intrahepatic portosystemic shunt, Ultrasonography, Stent function, Diagnosis

高晓婷, 高鑫, 刘艳莉, 康旺旺, 王海婷. 常规超声与超声造影评估肝硬化门静脉高压症患者TIPS术后支架功能价值分析^*[J]. 实用肝脏病杂志, 2025, 28(4): 589-592.

Gao Xiaoting, Gao Xin, Liu Yanli, et al. Comparison of conventional ultrasonography and contrast-enhanced ultrasonography in assessing stent function in patients with cirrhotics with portal hypertension after TIPS treatment[J]. Journal of Practical Hepatology, 2025, 28(4): 589-592.

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常规超声与超声造影评估肝硬化门静脉高压症患者TIPS术后支架功能价值分析^*

Comparison of conventional ultrasonography and contrast-enhanced ultrasonography in assessing stent function in patients with cirrhotics with portal hypertension after TIPS treatment

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