彩色多普勒超声诊断累及肝脏的遗传性、出血性毛细血管扩张症

目的探讨遗传性、出血性毛细血管扩张症患者累及肝脏时的彩色多普勒超声表现.方法用二维及彩色多普勒超声观察6例经临床明确诊断的遗传性、出血性毛细血管扩张症患者的肝脏及肝内外血管的走行及分布.结果 6例患者均表现为肝固有动脉纡曲扩张伴血流速度增快,5例同时伴有肝内动脉纡曲扩张;2例发现肝内动脉-静脉瘘,3例发现肝内动脉-门脉瘘;2例合并有肝硬化,其中1例同时合并有血管瘤.结论肝内外动脉纡曲扩张伴血流速度增快为累及肝脏的遗传性、出血性毛细血管扩张症的主要超声特点,彩色多普勒超声在此病的筛查、诊断及追踪观察等方面具有重要作用.

Color Doppler sonographic findings in hereditary hemorrhagic telangiectasia with hepatic involvement

Objective To explore color Doppler sonographic appearances of the liver in hereditary hemorrhagic telangiectasia. Methods Gray-scale and color Doppler sonography were used to study 6 patients with hereditary hemorrhagic telangiectasia and liver involvement. Parenchyma of the liver, vessel diameters, velocities of the hepatic artery and the portal vein were determined. Results The proper hepatic arteries of all 6 patients and the intrahepatic arteries of 5 patients were dilated and tortuous, and the flow velocities in them were increased. Intrahepatic arteriovenous shunts were observed in 2 patients, and arterioportal shunts were observed in 3 patients. Two patients were found with cirrhosis, in which one had hemagioma. Conclusion Dilation and increased velocity of hepatic artery and its branches were main characteristics of hepatic color Doppler sonographic in hereditary hemorrhagic telangictasia. These characteristics were of great value in screening, diagnosing, and following-up of the liver abnormalities in patients with hereditary hemorrhagic telangictasia.