先天性肝内型门-体静脉分流的MSCT和MRI表现  

MSCT and MRI Findings of Congenital Intrahepatic Portosystemic Venous Shunt

作　　者：彭沦 潘小舟 潘敏华[2] 林泽波 张应和 PENG Lun;PAN Xiao-zhou;PAN Min-hua;LIN Ze-bo;ZHANG Ying-he(Department of Imaging,Guangdong General Hospital,nanhai hospital,Foshan 528251,Guangdong Province,China;Special Diagnosis and Treatment Center,Foshan First People's Hospital,Foshan 528251,Guangdong Province,China)

机构地区：[1]广东省人民医院南海医院影像中心,广东佛山528251 [2]佛山市第一人民医院特需诊疗中心,广东佛山528000

出　　处：《中国CT和MRI杂志》2021年第1期132-134,143,共4页Chinese Journal of CT and MRI

基　　金：佛山市科技局医学类科技攻关项目(2017AB000442)。

摘　　要：目的分析先天性肝内型门-体静脉分流(CIPSVS)在多层螺旋CT(MSCT)和磁共振成像(MRI)中的表现。方法搜集8例CIPSVS患者的MSCT和MRI平扫和动态增强扫描检查资料,采用容积再现重组(VR)、最大密度投影(MIP)对动态增强扫描各期原始图像分别进行血管重建,分析其表现特点。结果8例CIPSVS发生于肝右叶5例,肝左叶1例,肝右叶和尾状叶2例。CT平扫7例连续多个层面见肝内圆形、椭圆形、管状稍低密度影;MRI1例平扫呈血管流空信号影。增强扫描动脉期无强化6例,不均匀强度强化2例,门脉期8例病灶均呈明显强化。门脉期VR、MIP均显示肝内病变区门静脉分支和肝静脉分支扩张,6例病变肝静脉汇入第二肝门,2例汇入第三肝门。4例门静脉分支见局限性瘤样扩张,其中,1例发生于门静脉分支行程中,1例发生于起始端,2例发生于末端。1例门静脉与肝静脉分支以网状血管相连,1例肝右后下静脉汇入第三肝门处呈相对局限性管腔狭窄。结论MSCT和MRI能准确诊断CIPSVS并清晰显示其解剖细节。Objective To analyze the manifestations of congenital intrahepatic portosystemic venous shunts on multislice spiral CT(CT)and magnetic resonance imaging(MRI).Methods We retrospectively reviewed 8 patients with CIPSVS.The image data of MRI and dynamic contrast enhanced(DCE)-CT were reconstructed in the manner of volume reconstruction(VR),any maximum intensity projection(MIP).The characters of them were analyzed and assessed.Results In all CIPSVS patients,1 case occurred in left lobe of liver,5 cases in right lobe of liver,2 cases in right lobe and caudate lobe of liver.7 cases detected by CT scanning were found slightly low density of round,oval and tubular shadow.1 case detected by MRI scanning showed vessel-emptied signals.1 case were detected on MRI,which shown as flow void signal.On arterial phase,6 cases showed no enhancement,whereas 2 cases presented as inhomogeneous enhancement.In portal and parenchymal phase,all the cases demonstrate marked homogenous enhancement.On VR and MIP images,dilatied portal vein and hepatic vein branches were found in 8 cases.Hepatic vein affluxed into the second hepatic portal in 6 cases,while 2 cases were found affluxed into the third portal.Localized tumor-like dilatation was found in 4 cases of portal vein branches,with 1 case occurred in the course of the journey,1 at the beginning of the portal vein,and 2 at the end of the portal vein.The portal vein branch from the beginning part of the portal vein to the hepatic vein confluent into the hepatic hilus showed the lumen patency.1 case showed the portal vein and hepatic vein branch connected by the reticular vessel.In 1 case,the right posterior inferior hepatic vein entered into the third hepatic hilum and the hepatic vein showed a relatively localized stenosis of lumen.Conclusion MSCT and MRI can accurately diagnose CIPSVS and display its anatomical details clearly.

关 键 词：门静脉畸形 门腔静脉分流 体层摄影术 X线计算机 磁共振 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]