肝内门-体静脉分流的彩色多普勒超声影像特征分析  

The imaging characteristics of intrahepatic portosystemic venous shunt detected by color Doppler ultrasound

作　　者：潘国栋 张瑶[1] 王雪梅 杨学平[1] PAN Guodong;ZHANG Yao;WANG Xuemei(Department of Ultrasound Diagnosis,Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015

出　　处：《河北医药》2022年第12期1879-1881,共3页Hebei Medical Journal

摘　　要：目的分析肝内门-体静脉分流的超声图像特征,提高超声医生对本病的认识和诊断能力。方法回顾性分析2017年1月至2020年4月39例超声发现的肝内门-体静脉分流患者超声图像特征。结果39例超声疑诊者均经增强CT或MRI确诊,超声诊断符合率100%,其中门静脉右后支-下腔静脉分流16例,门静脉右后支-肝右静脉分流13例,门静脉左支-肝左静脉分流5例,门脉右前支-肝中静脉分流3例,存在多处分流2例,超声表现为肝实质内囊状或迂曲管道状无回声,边界清晰,壁薄、光滑,辨别解剖关系可见其一端与肝内门静脉相通,另一端与肝静脉相通。可见分流处肝静脉内径增宽34例。CDFI:无回声内可见血流信号,血流方向为从门静脉流向肝静脉,频谱多普勒(PW)为静脉样频谱,相邻门静脉测得连续性低速血流,分流的肝静脉内可探及高速持续性血流。结论彩色多普勒超声检查敏感、便捷、无辐射,可成为临床诊断肝内门-体静脉分流的首选方法,为及时发现肝性脑病提供一种新的理论依据,使临床医生及早干预,避免或者延缓肝性脑病的发生。Objective To investigate the imaging characteristics of intrahepatic portosystemic venous shunt(IPSVS)detected by color Doppler ultrasound.Methods The imaging characteristics of IPSVS in 39 patients who underwent color Doppler ultrasound examination in our hospital from January 2017 to April 2020 were retrospectively analyzed.Results A total of 39 patients who were confirmed by enhanced CT or MRI were enrolled in the study,with ultrasound diagnose accordance rate being 100%.Of them,16 patients had right posterior portal vein-inferior vena cava shunt,13 patients had right posterior portal vein-right hepatic venous shunt and portal vein,and there were 5 cases of left branch-left hepatic venous shunt,3 cases of right anterior portal vein-middle hepatic venous shunt,and 2 cases of multiple shunts.The ultrasound examination showed there was echo in the liver parenchyma,with clear boundaries and thin walls,smooth,and one end was connected to the intrahepatic portal vein,and the other end was onnected to the hepatic vein.Of the 39 patients,the inner diameter of the hepatic vein at the shunt was widened in 34 patients.CDFI:The blood flow signal was visible in the anechoic,the blood flow direction was from the portal vein to the hepatic vein,and the spectral Doppler(PW)was the venous spectrum,the adjacent portal vein measures the continuous low-velocity blood flow,and the shunted hepatic vein could be detected by high-speed continuous blood flow.Conclusion The color Doppler ultrasonography is sensitive,convenient,and non-radiation,which can be regarded as the first choice for clinical diagnosis of IPSVS,which provides a new theoretical basis for timely detection of hepatic encephalopathy and enables clinicians to intervene early to avoid or delay the occurrence of hepatic encephalopathy.

关 键 词：肝静脉 门静脉 超声 肝内门-体静脉分流 

分 类 号：R445.14[医药卫生—影像医学与核医学]