关键词: 肝硬化, 食管胃底静脉曲张, 声脉冲辐射力弹性成像, 曲张静脉出血, 门静脉血栓

Abstract: Objective To investigate the value of acoustic radiation force imaging（ARFI） in evaluating varices hemorrhage and portal vein thrombosis in patients with esophagogastric varices（EGV） complicating cirrhosis. Methods 87 patients with cirrhosis and EGV were recruited in our hospital between April 2015 and June 2017,and liver parenchyma shear wave velocity（LSWV） and splenic shear wave velocity（SSWV） were measured by AEFI in all the patients. Logistic regression analysis was applied to analyze the risk factors of portal thrombosis in patients with cirrhosis,and the efficacy of LSWV and SSWV in the diagnosis of hemorrhage and portal vein thrombosis was analyzed by AUC. Results At the end of 3 month followed-up,the varices bleeding occurred in 34 patients;the LSWV and SSWV in patients with hemorrhage were （2.6±0.5） m/s and （3.3±0.5） m/s,respectively,significantly higher than [（1.9±0.4） m/s and （2.5±0.3） m/s,P<0.05] in 53 patients without;out of the 87 patients,25（28.7%） had portal vein thrombosis,and univariate and multivariate analysis showed that Child class,portal vein diameter,platelet counts,infection,ascites,hepatic encephalopathy,LSWV,SSWV,EGV classification and varices hemorrhage were the risk factors of portal vein thrombosis occurrence;the diagnostic efficacy of combined detection of LSWV and SSWV for portal venous thrombosis was high with the AUC of 0.893（0.829-0.946）. Conclusion The measurement of LSWV and SSWV by ARFI might be helpful in evaluating the existence of portal thrombosis in patients with liver cirrhosis and EGV.

Key words: Liver cirrhosis, Esophageal and gastric varices, Acoustic radiation force imaging, Varices bleeding, Portal venous thrombosi