儿童先天性门体静脉分流临床及CT表现  

Clinical and CT findings of congenital portosystemic venous shunts in children

作　　者：向永华[1] 金科[1] 徐和平[1] 甘清[1] 李春旺[1] XIANG Yong-hua;JIN Ke;XU He-ping(Department of Radiology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院放射科,长沙410007

出　　处：《放射学实践》2020年第10期1320-1323,共4页Radiologic Practice

基　　金：湖南省卫生健康委科研计划课题项目(C2019023)。

摘　　要：目的:探讨儿童先天性门体静脉分流CT表现,提高对其认识。方法:回顾性分析2013年4月-2019年10月在湖南省儿童医院确诊28例先天性门体静脉分流患儿临床及CT资料。结果:先天性门体静脉分流共28例,包括肝内门静脉瘘18例,静脉导管未闭5例,门-脐静脉分流1例及Abernethy畸形4例。肝内门静脉瘘中肝动脉-门静脉-肝静脉瘘14例,门静脉-肝静脉瘘4例,14例合并房间隔缺损。Abernethy畸形中Ⅰb型1例,Ⅱ型3例,3例合并先天性心脏病,1例合并肝性脑病。静脉导管未闭中4例合并先天性心脏病,4例合并肺动脉扩张,2例合并肝性脑病。门静脉-脐静脉分流1例,合并肝性脑病。结论:儿童先天性门体静脉分流种类多样,临床症状主要取决于分流量及发病年龄,常合并先心病,CT诊断关键在于对门静脉结构充分认识。Objective:To explore the clinical and CT findings of congenital portosystemic venous shunts in children and to expand the knowledge about the disease.Methods:The clinical and CT data of 28 patients with congenital portosystemic venous shunts diagnosed between April 2013 and October 2019 in Hunan Children’s Hospital were retrospectively analyzed.Results:The 28 cases of congenital portosystemic venous shunts,included 18 cases of intrahepatic portal venous fistula,5 cases of patent ductus venous,one case of portal-umbilical venous shunt(n=1)and 4 cases of Abernethy malformation.Intrahepatic portal venous fistula included 14 cases of hepatic arterio-portal-hepatic venous fistulas and 4 cases of portal-hepatic venous fistulas,complicating atrial septal defect in 14 cases.Abernethy malformations included typeⅠb(n=1)and typeⅡ(n=3),complicating congenital heart disease in 3 cases and hepatic encephalopathy in one case.Patent ductus venous complicated congenital heart disease in 4 cases,pulmonary artery dilatation in 4 cases and hepatic encephalopathy in 2 cases.Portal-umbilical venous shunt case complicated hepatic encephalopathy.Conclusion:The types of congenital portosystemic venous shunts in children were diverse.The clinical symptoms mainly depend on shunt volume and the age of patients.It is often complicated with congenital heart diseases.The key for CT diagnosis is to fully understand the structure of portal vein.

关 键 词：门体分流术 外科 儿童 体层摄影术 X线计算机 诊断 

分 类 号：R44[医药卫生—诊断学] R195.1[医药卫生—临床医学]