CT及DSA在肝小静脉闭塞症鉴别诊断中的应用  

Application and research of CT and DSA in the differential diagnosis of hepatic venular occlusive disease

作　　者：李红伟[1] 刘金朝 黄勇华[1] 杨思福[1] 

机构地区：[1]河南省濮阳市油田总医院介入科,河南濮阳457001

出　　处：《医学影像学杂志》2017年第10期1937-1940,共4页Journal of Medical Imaging

摘　　要：目的探讨CT及DSA在肝小静脉闭塞症鉴别诊断中的应用价值。方法收集2012年~2016年我院12例肝小静脉闭塞症、12例布加综合征和12例肝炎后肝硬化病例的临床资料,对其CT及DSA影像检查结果进行对比研究。结果 1)侧支循环显示情况:肝小静脉闭塞症组较少,与另两组差异有统计学意义(P<0.01);2)肝小静脉闭塞症可见肝脏弥漫性肿大(5例)、尾状叶增大(7例)、肝实质低密度斑片状区(3例)、肝实质弥漫性密度减低(8例),所有病例均可见中-大量腹水;布加综合征可见肝脏弥漫性肿大(3例)、尾状叶增大(9例),少数病例可见多发良性结节(2例)、腹水(4例);肝炎后肝硬化可见肝脏体积明显缩小(12例)、肝脏边缘波浪状(10例)、肝裂增宽(8例)、左叶增大(12例)、脾大(4例)、腹水(4例)等。肝小静脉闭塞症门脉期地图样强化,布加综合征特征的表现为扇样强化,而乙肝肝硬化则肝实质强化相对均匀。结论 CT及DSA在肝小静脉闭塞症的鉴别诊断中具有重要的应用价值。Objective To explore the application value of CT and DSA in the differential diagnosis of hepatic venular occlusive disease. Methods 12 cases of hepatic venular occlusive disease（ HVOD）,12 cases of Budd-Chiari syndrome and 12 cases of posthepatitic cirrhosis in our hospital from 2012 to 2016 were selected. The results of CT and DSA were compared. Results1） information of collateral circulation： there were less in hepatic venular occlusive disease group,differences were statistically significant with another 2 groups（ P 0. 01）; 2） In hepatic venular occlusive disease group： diffuse enlargement accounted for5 cases,caudate lobe enlargement for 7 cases,low-density patchy regions of the liver parenchyma for 3 cases,diffuse decreased attenuation of the liver parenchyma for 8 cases. Massive ascites were occurred in all the cases. In Budd-Chiari syndrome group：diffuse enlargement accounted for 3 cases,caudate lobe enlargement for 9 cases,multiple benign nodules for 2 cases and ascites for 4 cases. In posthepatitic cirrhosis group： live size shrank obviously accounted for 12 cases,liver with wavy margin for 10 cases,widening of inter lobar fissure for 8 cases,the left lobe increased for 12 cases,splenauxe for 4 cases and ascites for 4 cases.Conclusion CT and DSA had important application value in the differential diagnosis of hepatic venular occlusive disease.

关 键 词：肝小静脉闭塞症 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]