肝小静脉闭塞病的影像学分析(附4例报道)  

Imaging findings in four patients with hepatic veno-occlusive disease

作　　者：李云芳[1] 李宏军[1] 

机构地区：[1]首都医科大学附属北京佑安医院放射科,北京100069

出　　处：《磁共振成像》2011年第6期416-419,共4页Chinese Journal of Magnetic Resonance Imaging

基　　金：北京卫生系统高层次卫生技术人才培养计划项目(编号:2009-3-55)资助

摘　　要：目的探讨肝小静脉闭塞病(hepatic veno-occlusive disease,HVOD)的影像学特征。方法回顾性分析4例HVOD的临床及影像资料。4例行MRI三期增强扫描及超声检查,其中3例同时接受CT增强三期扫描。重点观察肝实质及肝血管的动态扫描变化并与平扫时进行比较。结果 2例经穿刺活检确诊,另外2例综合临床各项指征确诊。MR平扫显示肝大、腹腔积液、肝实质信号不均匀。增强扫描动脉期表现为全肝弥漫的信号不均匀改变,门静脉期表现具特征性的雪花片状强化与低灌注区呈补丁样分布,延迟期对比剂消退缓慢。CT平扫肝脏密度不均,增强扫描表现与MRI相似。超声显示4例病变肝静脉及下腔静脉均无梗阻。结论 HVOD在超声、平扫MRI和CT表现无特异性,动态增强扫描表现诊断价值较大。Objective： To discuss the imaging characteristics of the hepatic veno-occlusive disease （HVOD）. Materials and Methods： Four cases of HVOD were retrospectively analyzed. Each of the case was scanned by MRI in 3 dynamic phases after contrast enhancement and ultrasound. Three of the 4 cases were also dynamically scanned CT. The analysis was focused on the dynamic change of the parenchyma and the vasculature system and compared with that of pre-contrast images. Results： Two cases were diagnosed by biopsy with the other 2 confirmed by clinical signs. On pre-contrast MR images, enlarged liver, seroperitoneum, and heterogenous signal intensities of the parenchyma were revealed. On post-contrast images, the liver demonstrated nonhomogenous enhancement in arterial phase, patchy enhancement and low-perfusion in portal vein phase, and slow wash-out in delayed phase. The dynamic change on CT images was similar with that of MRI. All of the cases revealed non-obstructive hepatic veins and inferior vena cava in ultrasound examination. Conclusions： The findings of HVOD were non-specific in ultrasound, pre-contrast MR images, and pre-contrast CT. The signs of dynamic contrast images were more valuable for the diagnosis.

关 键 词：肝静脉闭塞性疾病 磁共振成像 诊断 

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]