超声造影在肝内门体静脉分流中的诊断价值  

Value of contrast-enhanced ultrasonography in the diagnosis of intrahepatic portosystemic venous shunt

作　　者：谭石[1] 傅强 刘士榕 刘昊 杨玉洁[1] 孙彦[1] 刘畅[1] 崔立刚[1] TAN Shi;FU Qiang;LIU Shi-rong;LIU Hao;YANG Yu-jie;SUN Yan;LIU Chang;CUI Li-gang(Department of Ultrasound,Peking University Third Hospital,Beijing 100191,China;Department of Ultrasound,Civil Aviation General Hospital,Beijing 100123,China)

机构地区：[1]北京大学第三医院超声科,北京100191 [2]民航总医院超声科,北京100123

出　　处：《哈尔滨医科大学学报》2018年第5期484-487,共4页Journal of Harbin Medical University

基　　金：科技部国家重点研发计划重点专项基金(2016YFC0104900)

摘　　要：目的研究肝内门静脉-肝静脉分流(IPSVS)的超声造影表现,探讨超声造影对于肝内门静脉-肝静脉分流的诊断价值。方法回顾性分析5例肝内门静脉-肝静脉分流患者的病史及临床资料,对5例患者6枚病灶进行实时灰阶超声造影(CEUS)和门体静脉血流量测量,观察病灶增强特点和时相变化,计算分流率。结果本组病例中肝内门静脉-肝静脉分流主要为ParkⅢ型(共5例),病灶处超声造影剂到达时间为14～20 s,与相应门静脉序列显影,病灶造影剂灌注均匀,灌注强度与门脉相同,引流肝静脉提前显影。4枚病灶彩色超声提示诊断,超声造影证实;其余2例中彩色多普勒超声疑诊1例,误诊1例,超声造影明确诊断。结论门体静脉分流ParkⅢ型的超声造影表现为病灶与相应门静脉序列显影,引流肝静脉提前显影,超声造影可以为IPSVS诊断提供确诊依据。Objective To investigate the contrast-enhanced ultrasonographic manifestations of the intrahepatic portosystemic venous shunt( IPSVS) and the clinical value of contrast-enhanced ultrasound( CEUS) in diagnosing the IPSVS. Methods The history and clinical data of 5 patients( 6 lesions) with IPSVS were retrospectively analyzed. The enhanced characteristics and phase changes of lesions were all obeserved by real-time CEUS,the portal and hepatic venou blood flow volumn was measured to calculate the shunt rate. Results IPSVS was mainly ParkⅢ type in this group of cases( 5/6 cases totally),the arriving time to the shunt of contrast enhanced agent was 14 - 20 seconds,the lesion was perfusioned by agent closely followed the portal vein,the intensity of perfusion of contrast enhanced agent was uniform with that of portal vein,and the display of drainaged hepatic vein was advanced than normal. Four lesions was diagnosed accurately by both colour doppler ultrasound and CEUS,and the other 2 cases confirmed by CEUS were respectively suspected and misdiagnosed by colour doppler ultrasound.Conclusion Park Ⅲ of IPSVS are familiar found in ultrasound examination,the portal vein and the shunt are displayed in sequence,and the hepatic vein is perfused in advance. The characteristic imaging of IPSVS and CEUS can offered direct reference to the diagnosis of IPSVS.

关 键 词：门静脉 肝静脉 分流 超声造影 

分 类 号：R445[医药卫生—影像医学与核医学] R657.3[医药卫生—诊断学]