超声影像对肝窦阻塞综合征的诊断价值

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1、万方数据中国超声医学杂志2008年第24卷第10期ChineseJUltrasoundMedVol24No102008超声影像对肝窦阻塞综合征的诊断价值蒋天安翁慧芳敖建阳陈芬赵齐羽黄敏陈燕一951一摘要目的探讨肝窦阻塞综合征(HSOS)的超声影像特点，并探讨其诊断价值。方法对24例HSOS患者行灰阶超声、彩色多普勒超声检查，并对其中3例行超声造影检查，结合临床资料综合分析其表现。结果本组病例特征性超声表现为肝静脉壁增厚并回声增强，肝静脉周围带状肝回声减低；其他有肝静脉狭窄及流速减慢、门静脉血流缓慢及肝实质受损征象。2例超声造影提示肝动脉一肝静脉渡越时

2、间延长。结论HSOS具有多种超声表现，其中肝静脉及其周围肝实质回声改变具有特异性，并与疾病的严莺程度相关；渡越时间延长提示HSOS肝内微循环血液回流受阻，证实其病理改变基础。因此，超声检查对该病的诊断具有重要意义。关键词肝窦阻塞综合征肝小静脉闭塞症超声检查超声造影SignificanceofUltrasonographyinDiagnosingHepaticSinusoidalAbstructiveSyndromeJiangTian'an，WengHuifang，AoJianyang，etalDepartmentofUltrasonography，t

3、heFirstAffiliatedHospital，CollegeofMedicine，ZhejiangUniversity，Hangzhou310003ChinaAbstract：ObjectiveToexploretheultrasonographicfeaturesofhepaticsinusoidalobstructivesyndrome(HSOS)orhepaticveno—occlusivedisease(HVOD)andtheirdiagnosticvalue．MethodsGray—scaleultrasoundandcolorDop

4、plerultrasoundwasperformedintwenty--threecaseswithHSOSthreeofwhomunderwentreal—-timecontrast—enhancedultrasonography．Theultrasonicimagingwascomprehensiveinanalyzedcombinedwithclinicaldata．ResultsTheuniqueultrasonicfeatureswerefoundasthethickeningandhyperechoichepaticvenous(HV)w

5、all，hypoechoicstripintheliverparenchymaaroundthehepaticvein；otherchangesincludednarrowingHV，bloodflowinHV，portalhypertensionandconcernedhepaticdamagesigns．Contrast-enhancedultrasonographyin2casesshowedthatthehepatictransit—timeofHSOSwasprolonged．ConclusionsHSOSwouldmanifestvari

6、ousultrasonicsings，amongwhichthewallchangeofHVandthehypoechoicstripisspecifictOHSOS，andrelatedtotheseverityofHSOS．Theprolongedtransit—timeindicatestheobstructionofintra—hepaticmicrocirculation。whichmayrevealthepathologicchangeofHSOSnon—invasively．Therefore，ultrasonographyisofgr

7、eatimportanceinthediagnosisofHSOS．Keywords：Hepaticsinusoidalobstructivesyndrome，Hepaticveno—occlusivedisease，Ultrasonography，Contrast—enhancedultrasonography．肝窦阻塞综合征(hepaticsinusoidalobstructivesyndrome，HSOS)又称为肝小静脉闭塞症(hepaticveno—occlusivedisease，HVOD)，较少见，其病理生理基础为肝窦流出道阻塞，Dele

8、ve等认为称本病为肝窦阻塞综合征n3更为合理。HSOS最常见的致病原因有2种，一是应用抗肿瘤化疗药物和免疫抑