肝硬化自发性门脉右后支-下腔静脉交通的螺旋CT表现

目的 :探讨肝硬化自发性门静脉右后支 下腔静脉交通的螺旋CT表现。材料和方法 :回顾性分析 8例自发性门静脉右后支 下腔静脉交通的螺旋CT双期增强扫描表现及其有关的临床表现。结果 :8例均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相连。 8例均有血氨升高 ,2例有肝性脑病。结论 :门静脉右后支 下腔静脉自发交通罕见 ;对其认识的加深有助于肝内病变的鉴别诊断和提示临床医师注意肝性脑病的可能性。

CT Manifestations of Spontaneous Right Posterior Portal Vein -IVC Shunts inPatients with Liver Cirrhosis

Purpose: To describe CT manifestations of eight cases with spontaneous right posterior portal vein IVC shunts(RPPV IVCs). Materials and Methods: Spiral CT(SCT) data and related clinical findings of 8 cases with liver cirrhosis who had spontaneous RPPV IVCs were retrospectively reviewed. SCT was performed using double phase enhanced scanning. Results: In all cases, SCT showed tortuous intrahepatic tubular structures which were all in the posterior segment of the right lobe connecting the right posterior portal vein to the inferior vena cava(IVC) in the suprarenal region.Blood ammonia levels were elevated in all cases and symptoms associated with hepatic encephalopahthy were present in two cases. Conclusion: The results suggested that knowledge of the SCT manifestation of RPPV IVCs is useful for the differential diagnosis of intra hepatic lesions and for the clinician to alert the possibility of the hepatic encephalopathy although it is extremely rare.