关键词: 超声造影定量参数, 超声血流参数, 肝硬化, 门静脉血栓, 诊断模型

Abstract: Objective To establish and verify a diagnostic model of hepatic cirrhosis complicated with portal vein thrombosis based on quantitative parameters of contrast-enhanced ultrasound (CEUS) and ultrasonic flow parameters. Methods Ninety-seven cirrhotic patients complicated with portal vein thrombosis admitted to the hospital from April 2019 to July 2023 were selected as the research group. Fifty-six cirrhotic patients without portal vein thrombosis admitted during the same time period were selected as the control group. All patients underwent ultrasound examination, and the quantitative parameters of contra-enhanced ultrasound [peak intensity, peak time and area under curve (AUC)] and ultrasonic blood flow parameters [portal vein diameter (PVD) and portal vein flow velocity (PVV) ] were recorded. The influencing factors of cirrhosis complicated with portal vein thrombosis was analyzed. The diagnostic model of cirrhosis complicated with portal vein thrombosis was constructed and validated. Results The values of AUC, peak intensity, and PVD in the research group were (2147.85±372.41) dB/s, (16.33±4.29) dB, and (16.83±4.67) mm, respectively, which were significantly higher than those of (1259.34±196.25) dB/s, (11.06±3.10) dB, and (12.26±3.35) mm in the control group (P<0.05). The time to peak and PVV in the research group were (47.19±6.58) s and (10.69±2.43) cm/s, respectively, which were significantly lower than those of (79.23±10.17) s and (14.98±3.65) cm/s in the control group (P<0.05). The values of aspartate aminotransferase, activated partial thromboplastin time (APTT), and alanine aminotransferase in the research group were 21.07±3.45 U/L, (27.15±4.38) s, and (29.48±4.71) U/L, respectively, which were significantly lower than those of 27.84±4.90 U/L, (30.24±5.66) s and (42.53±5.89) U/L in the control group (P<0.05). The D-dimer level in the research group was (3.19±0.57) mg/mL, which was significantly higher than that of (1.46±0.93) mg/mL in the control group (P<0.05). The Peak intensity (OR=5.135, 95%CI: 2.257~11.680), AUC (OR=4.540, 95%CI: 1.996~10.328), PVD (OR=5.801, 95%CI: 2.550~13.196), time to peak (OR=4.242, 95%CI: 1.865~9.649), PVV (OR=4.513, 95%CI: 1.984~10.267), and APTT (OR=0.237, 95%CI: 0.104~0.540) were identified as influencing factors for portal vein thrombosis in liver cirrhosis (P<0.05).The sensitivity of the nomogram model in the diagnosis of portal vein thrombosis was 89.69% (95%CI: 73.41%~94.15%), the specificity was 91.07% (95%CI: 74.28%~96.43%), and the AUC was 0.905 (95%CI: 0.882~0.963). Conclusion The diagnostic model of liver cirrhosis complicated with portal vein thrombosis which was constructed based on quantitative parameters (AUC, peak intensity, peak time) and ultrasonic blood flow parameters (PVD, PVV) is helpful for early screening of the risk patients.

Key words: Quantitative parameters of contrast-enhanced ultrasound, Ultrasonic blood flow parameters, Liver cirrhosis, Portal vein thrombosis, Diagnostic model