Analysis of the characteristics of color ultrasound examination
Although there are many variations of the gallbladder veins, they eventually converge into the portal vein system. Doppler ultrasound detection of portal hypertension gallbladder lesions has the advantages of sensitivity, specificity and noninvasiveness. Varicose veins of the gallbladder are relatively common lesions of portal hypertension. Color ultrasound is an important detection method for diagnosing this lesion, and it is superior to cholangiography, CT and MRI. West believes that ultrasound detection of BV is one of the evidences for the diagnosis of portal hypertension.
At present, most of the gallbladder varicose veins and thickening of the gallbladder wall in portal hypertension are found during imaging examination. There are few reports on pathological sections and ultrastructural examinations. Ultrasound examination is the best method and consensus has been reached. Extrahepatic portal vein embolism is considered to be the main cause of portal hypertensive gallbladder lesions, and portal cavernous degeneration is also one of the common causes. It is reported that about 30% of adult patients with extrahepatic portal embolism can be combined with BV; after analysis, BV is not related to the degree and location of portal embolism. Compared with other causes (such as cirrhosis), portal vein embolism is more common in children, but its BV has no obvious relationship with esophageal and gastric varices. BV due to cirrhosis and liver function in children (child-piogh classification ) Also seems irrelevant.
Regarding the mechanism of the formation of portal hypertensive gallbladder disease, Taiwan scholars believe that there are many factors involved, such as ascites, increased systemic blood flow resistance and increased portal pressure, etc. are the main factors, and found that when the hepatic vein wedge pressure is higher than At 10mmHg, BV is more obvious. BV is a common phenomenon in patients with cirrhosis and portal hypertension. Studies by foreign scholars have found that the thickness of the gallbladder wall and the cross-sectional area of ​​the gallbladder vein in the portal hypertension hamster are positively correlated with the portal pressure, and the contraction rate of the gallbladder is much lower than that of the normal hamster. Edema can thicken the gallbladder wall and reduce the contraction of the gallbladder.
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