肝内门静脉-体静脉分流的MRI表现  

MRI manifestations of intrahepatic portal-systemic venous shunt

作　　者：尤云峰 王明亮 曾蒙苏 YOU Yun-feng;WANG Ming-liang;ZENG Meng-su(Department of Radiology,Luoyang Dong Fang Hospital(the Third Affiliated Hospital of Henan University of Science and Technology),Luoyang 471003,China;Department of Radiology,Zhongshan Hospital,Fudan University/Institute of medical imaging/Department of Medical Imaging,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]河南科技大学第三附属医院洛阳东方医院影像科,河南洛阳471003 [2]复旦大学附属中山医院放射科,上海市影像医学研究所,复旦大学上海医学院影像学系,上海200032

出　　处：《中国临床解剖学杂志》2020年第4期396-400,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的探讨肝内门静脉-体静脉分流(intrahepatic portosystemic venous shunt,IPSVS)的MRI表现。方法回顾36例采用1.5T或3.0T MRI行上腹部平扫及动态增强扫描的IPSVS患者(PHVS 29例,PIVCS 7例)影像资料,分析其影像解剖学特点。结果IPSVS以Tanoue第1种类型的第1亚型(72.2%)和ParkⅡ型(58.3%)最常见。PHVS所在部位除肝Ⅰ段外其它段均存在,以Ⅲ、Ⅵ、Ⅷ段多见,分布在肝内、肝周及包膜下几率相仿,以1个病灶为主,2个及以上病灶少见,形态以结节状为主、动脉瘤状次之,迂曲状及混合形态少见,病灶长径多大于1.0 cm;PIVCS位于肝Ⅰ、Ⅵ、Ⅶ段,分布在肝内-肝周-肝外多见,肝内-肝周及包膜下次之,肝内少见,形态以混合形态的迂曲、结节状为主,病灶长径均大于1.0 cm。IPSVS于MRI平扫T1WI显示上下连续层面肝内的低信号与肝内血管相连,T2WI呈大部分流空的低信号和少许稍高信号,增强显示与病灶相交通的供血门静脉和引流的肝静脉、下腔静脉是其特征性的表现。结论MRI能较好地显示IPSVS的血管异常。Objective To investigate the MRI features of intrahepatic portal-systemic venous shunt.Methods Upper abdominal plain scan and dynamic contrast-enhanced scan were performed with 1.5 T or 3.0 T MRI. A retrospective research was carried out to analyze the imaging data of 36 patients with IPSVS(PHVS 29 cases, PIVCS 7 cases). Results The first subtype of the first type(72.2%) in Tanoue classification and Park Ⅱ(58.3%) classification were the most common types of IPSVS. The site of PHVS except the segment Ⅰ of the liver existed, and the segments Ⅲ, Ⅵ, and Ⅷ were more common. The distribution was similar in the liver and the perihepatic and subcapsular, with one lesion as the main lesion and two or more lesions rare. The morphology was mainly nodular, followed by aneurysm, and the sinusoidal and mixed forms were rare. The lesion size was mostly larger than 1.0 cm, and a few were less than 1.0 cm:PIVCS located in the liver Ⅰ, Ⅵ, Ⅶ segment, distributed in the liver-perihepatic-extrahepatic more common,intrahepatic-perihepatic and capsular next, rare in the liver. T1-weighted image, IPSVS showed that the low signal in the upper and lower continuous layers of the liver was connected with the intrahepatic vessels. T2-weighted image showed that most of the flow was low signal and a little high signal. The characteristic manifestation was the blood supply portal vein, drained hepatic vein and inferior vena cava. Conclusions MRI can show clearly and well the vascular abnormalities of IPSVS.

关 键 词：肝 门静脉 肝静脉 下腔静脉 静脉分流 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学]