目的 探讨先天性肝内门静脉-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l例为ParkⅡ型,其余均为ParkⅢ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清楚的囊状、管状及不规则形无回声,病灶大小为1.1 cm× 0.6 cm ～ 2.0 cm× l.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(P值均＞ 0.05). 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.
Objective To investigate the ultrasonographic features of congenital intrahepatic portosystemic venous shunt (CIPSVS) and to assess the clinical value of ultrasonography in the diagnosis of CIPSVS.Methods Six cases of CIPSVS diagnosed in our hospital between March 2010 and March 2012 and confirmed by enhanced computed tomography (CT) were retrospectively reviewed.Five of the six cases had follow-up data that was included in the analysis.Results Among the six CIPSVS cases,only one was classified as Park's type Ⅱ and the rest were classified as Park's type Ⅲ.Five cases involved the fight lobe of the liver and only one case involved the left lobe.The lesion shapes included cystic,tubular,and irregular with clear contour and appeared to be anechoic on CT scan.The lesions ranged in size from 1.1 × 0.6 cm to 2.0 × 1.7 cm.For all cases,the color Doppler ultrasound images showed blood flowing from the portal vein to the hepatic vein,and single-phase spectrum was detected in the diversion channel.The differences observed in level of lesion size and blood flow velocity at the shunt from the time of examinations at diagnosis and subsequent follow-up did not reach statistical significance (P =0.223 ＞ 0.05 and P =0.930 ＞0.05 respectively).Conclusion Although cases of CIPSVS are rare,they share some specific sonographic features that may help in diagnosis.Color Doppler ultrasound findings have high diagnostic accuracy and may represent a preferred modality for follow-up momitoring.