肝窦阻塞综合征的CT和MRI诊断  

CT and MRI Diagnosis of Hepatic Sinusoidal Obstructive Syndrome

作　　者：应世红[1] 徐晓俊[2] 张敏鸣[2] 

机构地区：[1]浙江大学医学院附属第一医院放射科,杭州310003 [2]浙江大学医学院附属第二医院放射科,杭州310009

出　　处：《临床放射学杂志》2011年第9期1302-1305,共4页Journal of Clinical Radiology

摘　　要：目的探讨肝窦阻塞综合征(HSOS)的CT和MRI影像特征。资料与方法回顾性分析25例临床或病理诊断为HSOS患者的CT和/或MRI增强扫描表现,其中22例有土三七服用史。结果 25例患者均可见以第二肝门为中心环绕三支肝静脉和下腔静脉的"爪"形稍高密度或T1WI稍高信号、T2WI稍低信号灶,并且增强扫描门静脉期明显强化,延迟期强化灶增大,强化更加明显。21例肝静脉未见对比剂充盈,2例模糊显示,1例显示肝静脉较细,1例仅左肝静脉清晰显示。肝脏肿胀21例,腹腔积液24例,门静脉增宽9例,脾静脉增粗8例,脾增大8例,食管胃底静脉曲张15例,胆囊壁增厚水肿12例,小肠壁增厚水肿4例,门静脉周围水肿1例。结论 HSOS的CT及MRI表现具有一定的特征,尤其是以第二肝门为中心环绕三支肝静脉和下腔静脉的"爪"形肝实质渐进性强化及肝静脉不强化或显影较差的表现,有助于准确诊断HSOS。Objective To explore the CT and MRI features of hepatic sinusoidal obstructive syndrome（HSOS）.Materials and Methods The dynamic enhanced MRI and/or CT findings of 25 cases with HSOS confirmed by clinic and pathology were retrospectively analyzed,22 of which had misused gymura segetum previously.Results In all cases,＂claw-shaped＂pattern lesions around hepatic veins and inferior vena cava were found in the second hepatic hilum area on plain CT scan or MRI,which enhanced on portal vein phase,in delayed scan,the hyperintensity area was extended with more obvious enhancement.Hepatic veins were not enhanced in 21 cases,faintly enhanced in 2,became thin in 1,left hepatic vein was only detected in 1.Of all 25 cases,hepatomegaly were observed in 21 cases,ascites in 24,augment of portal vein in 9,augment of spleen vein in 8,splenomegaly in 8,left gastric varices or lower esophageal varices in 15,wall thickening of the gallbladder in 12,wall thickening of small intestine in 4,and periportal edema in 1,respectively.Conclusion Non-enhanced hepatic veins and the ＂claw-shaped＂ pattern of stepwise enhancement around hepatic veins and inferior vena cava represent characteristic findings of HSOS,and which may help to suggest the correct diagnosis of HSOS.

关 键 词：肝窦阻塞综合征 肝小静脉闭塞症 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R816.5[医药卫生—诊断学]