先天性肝内门静脉-肝静脉分流的超声诊断-论文.pdf

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1、·940中华肝脏病杂志2013年l2月第2l卷第l2期ChinJHepatol，December2013，Vo1．21，No．12其他胛请先天性肝内门静脉一肝静脉分流的超声诊断傅强谭石崔立刚张华斌白志勇蒋洁【摘要】目的探讨先天l生肝内门静脉一肝静脉分流(CIPSVS)的超声表现及诊断价值。方法回顾性分析2010年3月至2012年3月间我院6例诊断为CIPSVS患者的临床资料及声像图特点。所有病例均经增强CT证实，其中5例随诊。复查后病灶大小，分流处流速经配对t检验。结果6例患者中1例为ParkII型，其余均为ParkIll型，其中5例发生于肝右叶，1例发生于肝左叶。灰阶超声表现为边界

2、清楚的囊状、管状及不规则形无回声，病灶大小为1．1cmx0．6cm～2．0cm×1．7cm；彩色多普勒显示为连接于门静脉及肝静脉之间的血流通道，分流通道内可探及单相血流频谱。复查前后病灶大小、分流处流速改变无统计学意义(尸值均>O．O5)。结论CIPSVS临床罕见，有较为特征性声像图表现，彩色多普勒超声能够准确地定性诊断，是随访观察的首选方法。【关键词】肝；超声检查，多普勒，彩色；诊断；门体静脉分流UltrasounddiagnosisofcongenitalintrahepaticportosystemicshuntFUQiang,ⅣShi,CUILi-gang,ZHANGHua—

3、bin，BAIZhi-yong,JIANG,lie．DepartmentofDiagnosticUltrasound,PekingUniversityThirdHospital,Beijing100191，ChinaCorrespondingauthor：TANShi,Email：tenshi@126．com[Abstract]0bjectiveToinvestigatetheultrasonographicfeaturesofcongenitalintrahepaticportosystemicvenousshunt(CIPSVS)andtoassesstheclinicalval

4、ueoful~asonographyinthediagnosisofCIPSVS．MethodsSixcasesofCIPSVSdiagnosedinourhospitalbetweenMarch2010andMarch2012andconfirmedbyenhancedcomputedtomography(CT)wereretrospectivelyreviewed．Fiveofthesixcaseshadfollow-updatathatwasincludedintheanalysis．ResultsAmongthesixCIPSVScases，onlyonewasclassif

5、iedasPark’StypeIIandtherestwereclassifiedasPark’StypeIII．Fivecasesinvolvedtherightlobeoftheliverandonlyonecaseinvolvedtheleftlobe．Thelesionshapesincludedcystic，tubular,andirregularwithclearcontourandappearedtobeanechoiconCTSCan．Thelesionsrangedinsizefrom1．1X0．6cmto2．0×1．7ClTI．Forallcases．thecol

6、orDopplerultrasoundimagesshowedbloodflowingfromtheportalveintothehepaticvein，andsingle-phasespectrumWasdetectedinthediversionchanne1．Thediferencesobservedinleveloflesionsizeandbloodflowvelocityattheshuntfromthetimeofexaminationsatdiagnosisandsubsequentfollow-updidnotreachstatisticalsignificance

7、=0．223>0．05andP=0．930>O．05respectively)．ConclusionAlthoughcasesofCIPSVSarerare，t11eysharesomespecificsonographicfeaturesthatmayhelpindiagnosis．ColorDopplerultrasoundfindingshavehighdiagnosticaccuracyandmayrepresentapreferredmodali