关键词: 乙型肝炎肝硬化, 食管胃底静脉曲张破裂出血, 超声造影, 脾静脉, 脾动脉

Abstract: Objective To investigate the value of splenic blood flow in diagnosing esophagogastric variceal bleeding (EGVB) in patients with hepatitis B virus (HBV) - related cirrhosis by contrast-enhanced ultrasonography (CEUS). Methods A total of 69 patients with HBV-related cirrhosis complicated by EGVB admitted to our hospital from April 2019 to April 2020 were included in the study. According to the occurrence of EGVB, the patients were divided into bleeding group (n=26) and non-bleeding group (n=43). After admission, CEUS was performed before treatment in both groups. Splenic artery resistance index, splenic artery pulsatility index, splenic vein diameter, mean splenic vein flow, minimum circulation time (MCT), and peak enhancement time (PET) were recorded. The difference of splenic blood flow between the 2 groups was compared, and the values of MCT and PET in the diagnosis of HBV-related cirrhosis complicated by EGVB were analyzed based on receiver operating characteristic (ROC) analysis. Results There was no significant difference in splenic artery resistance index, splenic artery pulsatility index, splenic vein diameter and splenic vein mean flow between the 2 groups (P>0.05). MCT and PET in the bleeding group were significantly higher than those in the non-bleeding group (P<0.05). Both MCT and PET could be used for the diagnosis of EGVB in patients with HBV-related cirrhosis based on ROC analysis. The areas under the curves were 0.775 and 0.866, respectively (P<0.05). Conclusion CEUS can be used in the diagnosis of EGVB in patients with HBV-related cirrhosis. MCT > 5.950 s and PET > 12.270 s are the best cutoff values for diagnosing EGVB in such patients, which is helpful to the clinical treatment.

Key words: Hepatitis B virus-related cirrhosis, Esophagogastric variceal bleeding, Contrast-enhanced ultrasonography, Splenic vein, Splenic artery