局灶性结节性增生引起布加综合征超声表现1例  

Ultrasound discovery of focal nodular hyperplasia causing Budd Chiari syndrome:a case report

作　　者：魏忠雪 张德智[1] Wei Zhongrue;Zhang Dezhi(Department of Abdominal Ultrasound,the First Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学第一医院腹部超声科,长春130000

出　　处：《中华超声影像学杂志》2025年第3期256-259,共4页Chinese Journal of Ultrasonography

摘　　要：局灶性结节性增生(FNH)通常发生在正常肝脏背景下,是第二常见肝脏良性病变,典型影像学表现为增强扫描门脉期及延迟期低强化,中央可见星状瘢痕。布加综合征(BCS)是一种罕见的肝血管疾病,定义为肝静脉流出道梗阻,分为原发性和继发性。患者女,20岁,因常规体检来吉林大学第一医院就诊,无明显不适,查体未见明显异常,既往体健,实验室检查未见异常。超声(超声造影)及增强CT提示:FNH;BCS。本例为巨大FNH压迫肝右静脉及下腔静脉所致的BCS,因存在下腔静脉经肝内回流的有效侧支循环,无门脉高压症等表现,患者拒绝行有创治疗。超声及超声造影可以实时、动态显像,观察肝内外血管阻塞及血流动力学变化情况,具有FNH及BCS典型影像学表现,对于该病的诊断提供了有力的证据。Focal nodular hyperplasia(FNH),which usually occurs in the context of a normal liver,is the second most common benign hepatic lesion,with typical imaging manifestations of hypointensification in the portal and delayed phases of enhancement scans,and a stellate scar visible in the center.Budd-Chiari syndrome(BCS)is a rare hepatic vascular disease defined as obstruction of the hepatic venous outflow tract and is categorized as primary and secondary.The patient was a 20-year-old female,who came to the First Hospital of Jilin University for routine physical examination,without no obvious discomfort,no definite abnormality on physical examination,previous physical fitness,no abnormality on laboratory tests.Ultrasound(contrast-enhanced ultrasound)and enhanced CT suggested:FNH;BCS.In this case,BCS was due to compression of the right hepatic vein and inferior vena cava by a giant FNH,the patient refused to undergo invasive treatment due to the presence of an effective collateral circulation of the inferior vena cava with intrahepatic return and the absence of portal hypertension and other manifestations.Ultrasound and contrast-enhanced ultrasound can be used for real-time and dynamic imaging to observe intra-and extra-hepatic vascular obstruction and hemodynamic changes,with typical imaging manifestations of FNH and BCS,providing strong evidence for the diagnosis of this disease.

关 键 词：超声检查 局灶性结节性增生 布加综合征 侧支循环 

分 类 号：R445.1[医药卫生—影像医学与核医学]