非肿瘤性肝内血管异常交通超声造影表现  

Contrast-enhanced ultrasound manifestations of nontumorous intrahepatic vascular shunts

作　　者：陈天娇 吕珂 桂阳 陈雪琪 姜玉新[1] CHEN Tianjiao;LYU Ke;GUI Yang;CHEN Xueqi;JIANG Yuxin(Department of Ultrasound,Chinese Academy of Medical Sciences,Peking Union Medical College,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院超声医学科,北京100730

出　　处：《中国医学影像技术》2025年第2期263-267,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(82171968);中央高水平医院临床科研专项(2022-PUMCH-B-065)。

摘　　要：目的观察非肿瘤性肝内血管异常交通超声造影(CEUS)特点。方法回顾性分析11例肝内血管异常交通患者资料,包括3例肝动脉-肝静脉、3例肝动脉-门静脉、1例肝动脉-门静脉及肝动脉-肝静脉及4例门静脉-肝静脉异常交通,观察其常规超声及CEUS表现。结果3例肝动脉-肝静脉异常交通及3例肝动脉-门静脉异常交通CEUS均见引流静脉早增强,局部肝实质早增强、无廓清;常规超声于其中2例显示部分交通部位,CEUS见该部位持续增强。1例肝动脉-门静脉及肝动脉-肝静脉异常交通并存,表现与上述两类异常交通类似。对于4例门静脉-肝静脉异常交通,常规超声均显示交通部位,CEUS均见引流肝静脉及交通部位持续增强,其中2例见局部肝实质一过性低增强。结论非肿瘤肝内血管异常交通包括超声无法直接显示的微小异常交通及可显示的异常交通;前者CEUS表现为引流静脉(门静脉或肝静脉)早增强,部分可见局部肝实质早增强、无廓清;后者表现为引流静脉及交通部位持续增强,伴或不伴局部肝实质一过性低增强。Objective To observe contrast-enhanced ultrasound(CEUS)manifestations of nontumorous intrahepatic vascular shunts.Methods Data of 11 patients with intrahepatic vascular shunts were retrospectively analyzed,including 3 cases of intrahepatic arteriovenous shunts,3 cases of hepatic arterioportal shunts,1 case of intrahepatic arterioportal shunt complicated with intrahepatic arteriovenous shunt and 4 cases of intrahepatic portosystemic shunts.The conventional ultrasound and CEUS manifestations were observed.Results In 3 cases of intrahepatic arteriovenous shunts and 3 cases of hepatic arterioportal shunts,CEUS showed early enhancement of draining veins,early enhancement of local liver parenchyma without washout,while conventional ultrasound showed partial shunts in 2 cases with continuous enhancement showed on CEUS.The findings of 1 case of intrahepatic arterioportal shunt complicated with intrahepatic arteriovenous shunt were similar to the above two.Among 4 cases of intrahepatic portosystemic shunts,conventional ultrasound displayed all shunts,continuous enhancement of the draining hepatic vein and shunts were observed with CEUS,and transient low enhancement of local liver parenchyma were noticed in 2 cases.Conclusion Nontumorous intrahepatic vascular shunts could be divided into microscopic shunts that ultrasound could not directly display and shunts ultrasound could display.The former was characterized by early enhancement of the draining vein(portal vein or hepatic vein)on CEUS,some with early enhancement and no washout of local liver parenchyma.The latter was characterized by continuous enhancement of drainage vein and shunts,with or without transient low enhancement of local liver parenchyma.

关 键 词：肝 血流动力学 超声检查 

分 类 号：R575[医药卫生—消化系统] R445.1[医药卫生—内科学]