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目的探讨肝硬化自发性肝内型门-体静脉交通(ISPS)的螺旋CT表现及其临床意义。方法回顾性地分析了15例肝内自发性门-体静脉交通的螺旋CT表现及有关临床资料。结果15例分为3种类型:①门静脉右后支型12例,表现为位于肝右叶后段的扭曲的管状阴影,呈血管性强化两端分别与门静脉右后支和肾上腺旁的下腔静脉(IVC)相连。②肝静脉型2例,表现为门静脉肝内分支在肝内与肝静脉分支相连。③肝顶型1例,表现为自肝顶部方叶发出血管向左上走行汇入左侧内乳静脉。15例中血氨升高11例,肝性脑病2例。结论门静脉右后支型、肝静脉型和肝顶型是肝硬化自发性肝内型门-体静脉交通的罕见类型,加深对其认识有助于肝内病变的鉴别诊断。
Objective To explore the spiral CT findings of hepatic cirrhosis with spontaneous intrahepatic portal vein-venous traffic (ISPS) and its clinical significance. Methods A retrospective analysis of 15 cases of spontaneous hepatic portal-venous traffic spiral CT findings and clinical data. Results 15 cases were divided into three types: ① 12 cases of right posterior branch of the portal vein showed twisted tubular shadow located in the posterior segment of the right lobe of the liver, showing vascular enhancement at both ends of the right posterior branch of the portal vein and inferior adrenal Vein (IVC) connected. ② 2 cases of hepatic vein type, manifested as portal vein hepatic branches in the liver and hepatic vein branch connected. ③ 1 cases of liver top type, manifested as blood vessels from the top of the liver to the left and upper left vein into the left side of the internal mammary vein. Eleven patients had elevated serum ammonia and two had hepatic encephalopathy. Conclusions Right posterior branch of portal vein, hepatic vein type and hepatic top type are rare types of spontaneous intrahepatic portal-venous traffic of cirrhosis. To deepen their understanding is helpful for the differential diagnosis of intrahepatic lesions.