肝小静脉闭塞病的螺旋CT动态增强表现  

Dynamic Contrast-Enhanced Spiral CT Features of Veno-Occlusive Disease

作　　者：赵亮[1] 王冬青[1] 张宇川[2] 殷瑞根[1] 李月峰[1] 

机构地区：[1]江苏大学附属医院影像科,江苏镇江212001 [2]江苏大学附属医院消化科,江苏镇江212001

出　　处：《实用放射学杂志》2011年第7期1035-1037,1057,共4页Journal of Practical Radiology

摘　　要：目的 探讨肝小静脉闭塞病（venoocclusive disease,VOD）螺旋CT动态增强表现及形成机制.方法 回顾性分析经病理证实的VOD病例11例,男7例,女4例,年龄39～72岁,平均47.5岁.全部病例均行CT动态增强扫描及血管造影检查,并经B超引导下肝组织穿刺活检.结果 11例患者CT平扫均显示肝脏肿大,9例肝实质密度减低,其中均匀性降低3例,不均匀性降低6例,表现为斑片状、＂地图样＂低密度区;动态增强扫描肝实质出现典型的斑片状、＂地图状＂强化和低灌注区,2例肝静脉显示狭窄;4例严重肝组织淤血、坏死,延迟10 min后肝实质内仍有散在低密度区.病理学上见肝窦扩张、淤血,肝细胞肿胀变性、坏死.结论 VOD的 CT动态增强扫描有一定的特征性表现,正确认识和掌握这些特征并结合临床药史,有助于VOD的诊断.Objective To approach the spiral CT manifestations and etiology of veno-occlusive disease（VOD）. Methods Eleven patients with VOD confirmed pathologically were retrospectively analysed. There were 7 men and 4 women, ranged from 39 - 72 years in age with average of 47.5 years old. All patients were scaned by plain CT and dynamic enhanced CT scan and the biopsy of livers were done under B-ultrasound guidance. Results On plain CT,hepatomegaly was showed in all cases, the density of livers reduced in 9 of them,including homogeneous in 3 and heterogeneous in 6, which appeared as ＂patch and map＂ low density area. Typical ＂patch and map＂ enhancement and hypoperfusion areas could be found at dynamic enhanced scan, the narrow hepatic veins were found in 2 cases ,congestion and necrosis presented in 4 cases,and there were still some low density areas in the livers after contrastenhanced scan 10 minutes later. The hepatic sinus were expanded and congestion,the cell of livers became denaturation and necrosis on pathology. Conclusion Some CT characteristics in VOD can be found at dynamic enhanced CT scan, which in combination with the drug history is helpful in diagnosis of VOD.

关 键 词：肝脏 肝小静脉闭塞病 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]