肝窦阻塞综合征的临床和影像学表现  

Clinical and Imaging Features of Hepatic Sinusoidal Obstruction Syndrome

作　　者：贾翠宇[1] 赵大伟[1] 冯骥良[1] 宋文艳[1] 王欣欣[1] JIA Cuiyu;ZHAO Dawei;FENG Jiliang(Department of Radiology,Beijing You'an Hospital,Capital Medical University,Beijing 100069,P.R.China)

机构地区：[1]首都医科大学附属北京佑安医院放射科,北京100069

出　　处：《临床放射学杂志》2022年第2期284-288,共5页Journal of Clinical Radiology

摘　　要：目的回顾性分析肝窦阻塞综合征(SOS)的临床及影像学特点。方法本研究对15例SOS的临床症状、实验室检查及影像学表现进行统计分析。13例患者行多排CT(MDCT)检查;3例患者进行了MDCT和MRI检查。回顾性研究得到了医院伦理委员会的批准。结果本组病例最常见的肝功能异常指标为总胆红素和直接胆红素、γ-谷氨酰转移酶和凝血酶原时间。增强后肝实质出现三种形态的强化方式:弥漫性分布3例,斑片状强化在肝内呈弥漫分布,主要出现在静脉期及延迟期,延迟期强化不均匀,其中1例呈弥漫的"羽毛"状强化表现;肝主静脉周围分布10例,斑片状强化呈融合状,分布在肝脏3支大静脉周围,呈"爪样"或"三叶草"状,同时外周可见散在的不规则斑片状强化,延迟期强化不均匀;肝脏外周强化为主2例,斑片状强化主要分布在肝脏周围,中央部仅见少量散在强化。其他伴随影像包括肝脏增大、胆囊壁增厚、腹腔积液、侧支循环。结论结合肝内特异性分布的斑片状强化和异常的肝功能检查,可以提高SOS的准确诊断。Objective To retrospectively analyze the clinical and imaging features of hepatic sinusoidal obstruction syndrome(HSOS). Methods The clinical symptoms, laboratory examination and imaging findings of 15 cases hepatic sinusoidal obstruction syndrome were statistically analyzed.Thirteen patients had performed MDCT;three patients had both MDCT and MRI examinations.The retrospective study was approved by the hospital’s ethics committee. Results The most common abnormal liver function in this research ware jaundice(100%),Gamma-glutamyl transferase(100%) and prothrombin time(100%).Liver parenchyma showed three types of patchy changed after enhancement on MDCT or MR:patchy enhancement diffuse distribution in the liver in 3 cases(20%),abnormal enhancement showed in the venous phase and delay phase, and 1 case showed diffuse "feathers" inhomogeneous enhancement;The patchy enhancement were distributed around the hepatic main vein in 10 patients(66.7%),which presented a fusion shape, "claw" or "clover" shapes.The irregular patchy enhancement showed scattered around the periphery simultaneously.The peripheral enhancement was mainly features in 2 cases(13.3%),and only a small amount of scattered enhancement was found in the central part.Other accompanying findings included liver enlargement(100%),gallbladder wall thickening(93.3%),ascites(93.3%),collateral circulation(80%). Conclusion To combination of patchy enhancement with specific distribution and abnormal liver function can improve the accurate diagnosis of hepatic sinus obstruction syndrome.

关 键 词：肝脏 窦性梗阻综合征 体层摄影术 X线计算机 磁共振成像 

分 类 号：R575[医药卫生—消化系统]