动态增强CT对肝小静脉闭塞症的诊断价值  

Dynamic contrast-enhanced CT in diagnosis of hepatic veno-occlusive disease

作　　者：唐文娟[1] 史河水[1] 梁波[1] 刁楠[1] 梁斌[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《放射学实践》2012年第11期1235-1237,共3页Radiologic Practice

摘　　要：目的:探讨肝小静脉闭塞症的MSCT表现及CT动态增强扫描对本病的诊断价值。方法:回顾性分析12例经病理、临床证实的肝小静脉闭塞症患者的CT影像资料,总结其CT表现。结果:CT平扫:12例患者肝脏体积增大,肝实质呈局限性或弥漫性密度减低。增强扫描动脉期:10例(10/12)肝总动脉及左右分支增粗,肝内出现紊乱的网状血管;2例(2/12)同平扫相比无异常强化改变。门静脉期:9例(9/12)肝实质呈斑片状或地图状不均匀强化,肝内小静脉未显示,肝段下腔静脉改变(其中5例肝段下腔静脉呈明显逗号状,4例管腔变窄呈短条状),下腔静脉远端未见明显扩张及侧支形成;3例(3/12)肝内静脉显影较淡,管径明显变细。实质期:肝脏改变与门脉期相似。结论:肝小静脉闭塞症的多层螺旋CT表现有一定特征性,结合临床表现和病史可提高影像诊断准确性。Objective：To study the dynamic contrast-enhanced CT findings of hepatic veno occlusive disease （HVOD） and evaluate its usefullness in diagnosis of this disorder by using multi slice spiral CT. Methods：Twelve patients with patho- logically and elinically confirmed HVOD were recruited. All CT images were reviewed and the imaging features of the dis- ease were summarized. Results：On plain CT scan, the liver volume increased and the parenchyma appeared localized or dif fuse hypodense in 12 patients. On hepatic arteral phase scans, the widening of the common hepatic artery and its main branches in association with disordered reticular intrahepatic vessels were found in 10 patients,and in 2 of the 10 cases,the hypodense parenchyma showed no abnormal enhancement compared with the unenhanced phase. On portal venous phase, hepatic parenchyma demonstrated pathy or map-like heterogeneous enhancement in 9 patients, no intrahepatic venule was noted,while the hepatic inferior vena eava of 5 in the 9 cases manifested comma--shaped, and the other 4 presented nar- rowed lumen like short strip. No visible distal dilatation or collateral formation was observed. The major hepatic veins, with obviously small diameter,were slightly opacified in only 3 patients. On hepatic parenchymal phase, the imaging findings of liver were similar to those on portal venous phase. Conclusion： HVOD has characteristic features on multi-slice spiral CT scans. Combined with clinical manifestations and history,CT can improve the diagnosis rate of the disease.

关 键 词：肝脏病变 肝小静脉闭塞征 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]