特发性门静脉高压症的彩色多普勒超声诊断与临床价值

蔡敏娴; 林礼务; 薛恩生; 何以敉; 林学英; 杨嘉嘉

特发性门静脉高压症的彩色多普勒超声诊断与临床价值

福建医科大学附属协和医院超声科

详细信息

中图分类号: R575.29;R445.1
计量
- 文章访问数: 2653
- HTML全文浏览量: 9
- PDF下载量: 993
- 被引次数: 0
出版历程
- 出版日期: 2009-05-20

摘要

摘要: 目的探讨特发性门静脉高压症(IPH)的声像图特征,评价彩色多普勒对IPH的临床诊断价值。方法对25例IPH患者进行彩色多普勒超声检查,观察肝脏表面、内部回声、脾脏大小及肝内外门静脉系统等。结果25例患者中,25例均见门静脉肝内分支管壁增厚、回声增强、管腔狭窄甚至闭塞,15例实质回声增粗,门静脉海绵样变性22例,门静脉系统血栓5例,均为门静脉主干、脾静脉及肠系膜上静脉血栓,15例伴有胆道系统的异常。结论临床上不明原因的门脉高压及脾功能亢进患者均应进行彩色多普勒超声检查,肝内门静脉分支管壁增厚、管腔狭窄甚至闭塞的特征性改变及门静脉海绵样变性可提示IPH。
- 特发性门静脉高压症 /
- 彩色多普勒超声检查 /
- 门静脉海绵样变性
Abstract: Objective To explore the characteristics of idiopathic portal hypertension (IPH) on color Doppler images and to assess the diagnostic value of color Doppler on IPH.Methods Color Doppler sonography was performed to assess the surface and interior echoes of liver, the size of spleen and portal vein system in twenty-five IPH patients.Results In 25 patients undergoing color Doppler examination, intrahepatic portal vein appeared thickened wall, enhanced echoes, stenosis or occlusion in all cases, and coarse liver parenchyma was found in 15 cases, portal vein system cavernous transformation in 22 cases, thrombosis in portal vein system in 5 cases which involved main portal vein, splenic vein and superior mesenteric vein.Fifteen patients had detectable biliary tract pathology by ultrasound examination.Conclusion Color Doppler plays an important role in the diagnosis of IPH.In clinical practice, patients with portal hypertension and hypersplenisa for unknown aetiology should receive color Doppler examination.As thickened enhanced wall, stenosis or occlusion of intrahepatic portal vein and cavernous transformation were appeared, the diagonsis of IPH would be suggested.
- idiopathic portal hypertension /
- color Doppler /
- cavernous transformation of portal vein

HTML全文

参考文献(16)

[1]王莉, 袁孟彪.免疫机制在特发性门脉高压症发病中的作用[J].国外医学消化疾病分册, 2005, 5:289-291.

[2]Dhiman RK, Chawla Y, Vasishta RK, et al.Non-cirrhotic portal fi-brosis (idiopathic portal hypertension) :experiencewith151patients and a review of the literature[J].J Gastroenterol Hepatol, 2002, 17 (1) :6-16.

[3]Okudaira M, Ohbu M, Okuda K.Idiopathic portal hypertension and its pathology[J].Semin Liver Dis, 2002, 22 (1) :59-72.

[4]Okuda K.Non-cirrhotic portal hypertension versus idiopathic portal hypertension[J].J Gastroenterol Hepatol, 2002, 17 (1) :204-213.

[5]高艳景, 袁孟彪.特发性门静脉高压症研究进展[J].临床肝胆杂志, 2000, 16 (1) :20-21.

[6]Centeno JA, Mullick FG, martinezL, et al.Pathology related to chro-nic arsenic exposure[J].Environ Health Perspect, 2002, 110 (Suppl5) :883-886.

[7]Pimentel JC, Menezes AP.Liver disease in vineyard sprayers[J].Gastroenterology, 1977, 72 (2) :275-283.

[8]Thomas LB, Popper H, Berk PD, et al.Vinyl-chloride-induced liver disease.From idiopathic portal hypertension (Banti’s syndrome) to angiosarcomas[J].N Engl J Med, 1975, 292 (1) :17-22.

[9]Noel C, HazzanM, Copp inMC, et al.Idiopathic portal hypertension:an infrequent complication of renal transplantation[J].Transplant Proc, 1995, 27 (4) :2437.

[10]Nakanuma Y, Tsuneyama K, OhbuM, et al.Pathology and pathogen-esis of idiopathic portal hypertension with an emphasis on the liver[J].Pathol Res Pract, 2001, 197 (2) :65-76.

[11]Yamaguchi N, Tokushige K, Haruta I, et al.Analysis of adhesion molecules in patients with idiopathic portal hypertension[J].J Gas-troenterol Hepatol, 1999, 14 (4) :364-369.

[12]李铭, 宫振波, 李建初.门脉海绵样变性的影像学诊断进展[J].中国误诊学杂志, 2007, 12 (7) :6728-6729.

[13]Shimamatsu K, Wanless IR.Role of ischemia in causing apoptosis, atrophy, and nodular hyperplasia in human liver[J].Hepatology, 1997, 26:343-350.

[14]林学英, 林礼务, 薛恩生, 等.彩色多普勒超声对特发性门静脉高压症的诊断价值[J].中华医学超声杂志 (电子版) , 2007, 4 (5) :287-289.

[15]Imai Y, Kawata S, Tarui S.Elevated serum bile acids in hepatic vein occlusion and idiopathic portal hypertension[J].Clinica Chimica Ac-ta, 1991, 199:109-112.

[16]Chiu B, Superina R.Extrahepatic Portal Vein Thrombosis is Associ-ated With an Increased Incidence of Cholelithiasis[J].J Pediatr Surg, 2004, 39 (7) :1059-1061.

施引文献

资源附件(0)

访问统计