门静脉栓塞病变的超声表现及病因分析  

Ultrasonic features and etiological analysis of portal vein embolization

作　　者：沈燕华[1] 张云山[1] 贺声[1] 薛海萍[1] 鲁媛媛[1] 杨克[1] 

机构地区：[1]中国人民解放军海军总医院超声医学科,北京100048

出　　处：《中国医学影像技术》2014年第6期885-888,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察门静脉栓塞病变(PVE)超声表现,分析其病因。方法回顾性分析257例经病理、其他影像学检查或临床证实的PVE患者的临床和超声资料,观察栓子超声表现,分析病因、性质及发生部位。结果 PVE超声表现为门静脉系统内异常回声,部分或完全充填管腔;8例栓子内可见搏动性动脉血流信号(8/257,3.11%),25例(25/257,9.73%)门静脉(PV)呈海绵样变。PVE常见病因依次为为原发性肝癌(173/257,67.31%)、肝硬化(36/257,14.01%)及肝转移癌(30/257,11.67%)。194例(194/257,75.49%)PV癌栓中,原发性肝癌占80.41%(156/194);血栓63例(63/257,24.51%),其中肝硬化占57.14%(36/63)。PVE累及部位依次为门静脉主干及分支(254/257,98.83%)、肠系膜上静脉(36/257,14.01%)、脾静脉(30/257,11.67%)、下腔静脉(19/257,7.39%)、肠系膜下静脉(1/257,0.39%)。超声诊断门静脉癌栓的敏感度为4.12%(8/194)。结论 PVE超声表现具有一定特征,但超声鉴别诊断栓子性质敏感度较低;原发性肝癌为PVE的最常见病因。Objective To investigate ultrasonic features of portal vein embolization（PVE）, and to analyze the causes of PVE. Methods Clinical and ultrasonic data of 257 PVE patients confirmed by pathology, other imaging examination or clinical observation were retrospectively analyzed. Ultrasonic findings, cause, nature and location of PVE were investigated. Results PVE showed as intravenous abnormal echo, partially or completely filled the lumen on ultrasound. Pulsatile arterial blood flow signals in PVE were observed in 8 cases （8/257, 3.11%）, while cavernous transformation of the portal vein were observed in 25 cases （25/257, 9.73%）. The common causes of PVE were primary liver cancer （173/257, 67.31%）, cirrhosis （36/257, 14.01%） and liver metastases （30/257, 11.67%）. There were 194 cases （194/257, 75.49%） of tumor thrombus with primary liver cancer accounted for 80.41% （156/194） and 63 cases （63/257, 24.51%） of thrombosis with cirrhosis accounted for 57.14% （36/63）. The invaded locations were portal vein trunk and branches （254/257, 98.83%）, superior mesenteric vein （36/257, 14.01%）, splenic vein （30/257,11.67%）, inferior vena cava （19/257, 7.39%） and inferior mesenteric vein （1/257, 0. 39%）, respectively. The sensitivity of ultrasound in diagnosing tumor thrombus was 4.12% （8/194）. Conclusion PVE has certain characteristics on ultrasound, but the sensitivity of ultrasound in diagnosing tumor thrombus was low. Primary liver cancer was the most common cause of PVE.

关 键 词：超声检查 多普勒 彩色 门静脉 栓塞 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]