COLOR DOPPLER ULTRASOUND OF THE LIVER CIRCULATION
Autori:
Ivica Grgurević, Bita Boozari, Milan Kujundžić, Boris Brkljačić
Sažetak
Sažetak. Primjenom ultrazvuka i obojenog doplera (CDUS – od engl. Color doppler ultrasound) mogu se analizirati morfološke i hemodinamske promjene jetrenog krvotoka koje nastaju u različitim patološkim stanjima. U nekim od ovih stanja obojeni dopler ima presudnu ulogu u postavljanju dijagnoze, čime se mogu izbjeći invazivne pretrage. Osim uloge u analizi vaskularnih bolesti jetre, kao i reperkusija općih cirkulacijskih poremećaja na jetru, ovom metodom mogu se dobiti informacije bitne za karakterizaciju difuznih i fokalnih bolesti jetre. Prednost ultrazvuka pred ostalim metodama je u njegovoj širokoj dostupnosti i neinvazivnosti, a nedostatak je u činjenici da se radi o metodi koja vrlo ovisi o vještini, znanju i iskustvu ultrasoničara. U ovom radu prikazali smo aktualni status CDUS-a u dijagnostici kongestivnih bolesti jetre (Budd-Chiarijev sindrom, bolesti desnog srca, venookluzivna bolest), promjena na razini jetrenog parenhima (vaskularne anomalije-fistule, solidni tumori, promjene koje nastaju kod difuznih parenhimskih bolesti jetre) te smetnja utoka krvi u jetru (stenoza i tromboza jetrene arterije i vene porte).
Summary
Summary. Color Doppler Ultrasound (CDUS) is a valuable method for evaluation of morphological and hemodynamic changes of liver circulation occurring in various pathological conditions. In some of these conditions CDUS has a decisive diagnostic role, thus making further, potentially harmful invasive diagnostic procedures unnecessary. Except for the analysis of vascular liver diseases, as well as repercussions of circulatory impairment to the liver, utilization of CDUS provides valuable information for characterization of diffuse parenchymal and focal liver lesions. CDUS has advantages as compared to the other imaging modalities as it is widely available and noninvasive. The possible disadvantage is not related to the method itself, but is due to lack of expertise, i.e. training of the operator. In this article we review the present position of CDUS in evaluation of impairment of liver circulation: disorders of the venous outflow from the liver (Budd-Chiari syndrome, right-sided heart diseases, veno-occlusive disease), disorders of/in liver parenchyma (vascular anomalies-fistulae, solid tumors, circulatory changes that occur in diffuse liver diseases) and obstruction of the blood inflow to the liver (stenosis and thrombosis of hepatic artery and portal vein).
