特发性非肝硬化门静脉高压症患者肝脏影像学和病理学特征分析  

Imaging and histopathological features in patients with idiopathic non-cirrhotic portal hypertension

作　　者：许青 杨健[2] 宗金娟 Xu Qing;Yang Jian;Zong Jinjuan(Department of Ultrasound,People's Hospital,Liyang 213300,Jiangsu Province,China)

机构地区：[1]江苏省溧阳市人民医院超声科,213300 [2]苏州大学附属第一医院普外科

出　　处：《实用肝脏病杂志》2023年第1期91-94,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:21002901-411-137)

摘　　要：目的分析特发性非肝硬化门静脉高压症(INCPH)患者肝脏影像学和病理学特征,并与肝硬化的鉴别要点.方法2016年1月~2021年7月我院收治的INCPH患者16例和乙型肝炎肝硬化患者28例,常规进行超声、CT和MRI及肝穿刺活检检查.结果INCPH与肝硬化患者在影像学检查发现的弥漫性结节样改变(0.0%对35.7%)、门静脉直径[9.7(7.2,11.6)mm对13.6(9.2,15.7)mm]、门静脉壁厚[2.6(1.4,4.0)mm对1.4(1.1,1.6)mm]方面比较,差异具有统计学意义(P<0.05);肝组织学检查发现,INCPH与肝硬化患者在门静脉区域纤维化、肝膈膜纤维化、肝小叶间静脉闭塞、肝细胞坏死和肝细胞水肿或脂肪变性方面[分别为100.0%对0.0%、18.7%对92.8%、56.2%对10.7%、0.0%对75.0%和12.5%对89.3%],差异具有统计学意义(P<0.05).结论INCPH仍是一种病因不明的疾病,注意分析影像学和组织病理学特征可以作出与肝硬化的鉴别诊断.Objective The aim of this study was to summarize the imaging and liver histopathological features in patients with idiopathic non-cirrhotic portal hypertension(INCPH)and to find the differential clue from patients with liver cirrhosis(LC).Methods Sixteen patients with INCPH and twenty-eight patients with hepatitis B-induced LC were encountered in our hospital between January 2016 and July 2021,and all underwent ultrasonography,CT,MR and liver biopsies.Results The imaging check-up showed that there were significant differences as respect to liver diffuse nodular changes(0.0%vs.35.7%),portal vain diameters[9.7(7.2,11.6)mm vs.13.6(9.2,15.7)mm],and portal vain wall thickness[2.6(1.4,4.0)mm vs.1.4(1.1,1.6)mm]between the two groups(P<0.05);the liver histopathological examination demonstrated that there were significant differences respect to portal vein region fibrosis,hepatic diaphragm fibrosis,hepatic interlobular vein occlusion,hepatocyte necrosis or edema and hepatocyte steatosis[100.0%vs.0.0%,18.7%vs.92.8%,56.2%vs.10.7%,0.0%vs.75.0%and 12.5%vs.89.3%]between the two groups(P<0.05).Conclusion INCPH is still a disease of unknown etiology.The liver imaging and histopathological features might help differentiate it from liver cirrhosis.

关 键 词：特发性非肝硬化门静脉高压症 肝硬化 影像学表现 门静脉区域纤维化 

分 类 号：R575.2[医药卫生—消化系统]