CAJ | 학술논문

目的探讨先天性肝内门-体静脉分流(IPSVS)的彩色多普勒和超声造影表现.方法对19例经CT血管成像证实的先天性IPSVS患者行常规超声和超声造影检查,记录造影剂到达肝动脉时间(HAAT)、到达门静脉时间(PVAT)及到达肝静脉时间(HVAT),计算造影剂从肝动脉到达肝静脉间隔时间(HA-HVTT)和门静脉到达肝静脉间隔时间(PV-HVTT).结果病变的特征基于Park分型进行归类,彩色多普勒超声显示门静脉分支和肝静脉或下腔静脉之间的异常交通,脉冲多普勒显示分流门静脉出现类似于肝静脉起伏的三相波形.超声造影在门脉相显示门静脉分支和肝静脉或下腔静脉之间的异常交通血管,而且HVAT、HA-HVTT、PV-HVTT缩短,与肝硬化组及正常组比较差异均有统计学意义(P＜0.01).结论先天性IPSVS是罕见的血管异常,通常无症状,超声是诊断先天性IPSVS有效的工具,超声造影可为先天性IPSVS的诊断和鉴别诊断提供依据.
목적 탐토선천성간내문-체정맥분류(IPSVS)적채색다보륵화초성조영표현.방법 대19례경CT혈관성상증실적선천성IPSVS환자행상규초성화초성조영검사,기록조영제도체간동맥시간(HAAT)、도체문정맥시간(PVAT)급도체간정맥시간(HVAT),계산조영제종간동맥도체간정맥간격시간(HA-HVTT)화문정맥도체간정맥간격시간(PV-HVTT).결과 병변적특정기우Park분형진행귀류,채색다보륵초성현시문정맥분지화간정맥혹하강정맥지간적이상교통,맥충다보륵현시분류문정맥출현유사우간정맥기복적삼상파형.초성조영재문맥상현시문정맥분지화간정맥혹하강정맥지간적이상교통혈관,이차HVAT、HA-HVTT、PV-HVTT축단,여간경화조급정상조비교차이균유통계학의의(P＜0.01).결론 선천성IPSVS시한견적혈관이상,통상무증상,초성시진단선천성IPSVS유효적공구,초성조영가위선천성IPSVS적진단화감별진단제공의거.
Objective To evaluate the color Doppler ultrasonography and contrast enhanced ultrasound (CEUS) findings of congenital intrahepatic portosystemic venous shunts (IPSVS).Methods Nineteen patients of congenital IPSVS were examined with color Doppler ultrasonography and CEUS.All patients were confirmed by CT angiography.The hepatic artery arrival time (HAAT),portal vein arrival time (PVAT),and hepatic vein arrival time (HVAT) on CEUS were recorded.The interval time between hepatic artery arrival time and hepatic vein arrival time (HA-HVTT) and the interval time between portal vein arrival time and hepatic vein arrival time (PV-HVTT) were calculated.Results The types of IPSVS between portal and systemic veins were based on Park's classification.Color Doppler ultrasonography showed abnormal communication between the portal vein branch and the hepatic veins,duplex Doppler ultrasonography showed abnormal spectral pattern from the portal vein such as undulating,triphasic waveform mimicked that of the hepatic vein.CEUS demonstrated abnormal communication between portal vein branch and hepatic vein.HVAT,HA-HVTT,and PV-HVTT were shorter statistically in congenital IPSVS group than those in cirrhosis and normal groups.Conclusions Congenital IPSVS is a rare vascular abnormality that is usually asymptomatic.Color Doppler ultrasonography is a useful tool for diagnosis of congenital IPSVS.CEUS provides helpful data for the diagnosis and differential diagnosis of congenital IPSVS.