产前超声诊断肝内门静脉-肝静脉瘘的价值

目的探讨产前超声诊断胎儿肝内门静脉-肝静脉瘘的临床价值。方法回顾性分析5例胎儿肝内门静脉-肝静脉瘘的超声图像特征,并追踪其预后。结果 5例肝内门静脉-肝静脉瘘中,1例多处吻合伴静脉导管缺如,经引产及血管铸形证实门静脉与肝静脉有5处吻合,其他4例均为单支吻合,经产后追踪3例已闭锁,1例仍有小的交通支。肝内门静脉-肝静脉瘘的主要超声特征有:(1)肝静脉扩张;(2)门静脉与肝静脉交通;(3)门静脉与肝静脉瘘的门静脉端血流频谱呈三相波形。结论产前超声诊断胎儿肝内门静脉-肝静脉瘘具有较高的准确率,可为临床干预提供重要参考。

The Value of Prenatal Ultrasound in Diagnosing Intrahepatic Portal Vein-hepatic Vein Fistula

Objective To investigate the clinical value of prenatal ultrasound in the diagnosis of fetal hepatic portal vein-hepatic vein fistula.Methods The ultrasonic characteristics of fetal hepatic portal vein-hepatic vein fistula in 5 cases were retrospectively and the prognosis was cmalyed.Results In 5 cases of intrahepatic portal vein-hepatic vein fistula,1 case with multiple anastomosis and venous catheter deficiencies confirmed by vasculer casting that there were5 portal vein and hepatic vein anastomosis after induction of lakor.The other 4 cases were all single anastomosis,after postpartum follow-up,3 cases have been blocked,and 1 case still has a small traffic branch.The main ultrasound features of intrahepatic portal vein-hepatic vein fistulas:(1)Hepatic vein dilatation;(2)The communication of portal vein with hepatic vein;(3)The blood flow spectram at the portal vein end presentcd a three-phase waveform in portal vein and hepatic vein fistula.Conclusions Prenatal ultrasound diagnosis of fetal intrahepatic portal vein-hepatic vein fistula is highly accurate and can provide important reference for clinical intervention.