• 1.四川大學(xué)華西醫(yī)院放射科（成都 610041）;;
  • 2.四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院放射科（成都 610072）;

目的 探討特發(fā)性肝動(dòng)靜脈畸形（idiopathic hepatic arteriovenous malformation，IHAVM）的多層螺旋CT（multi-detector row spiral CT，MDCT）和磁共振成像（magnetic resonance imaging，MRI）的表現(xiàn)特征，并評(píng)價(jià)它們的診斷價(jià)值。方法 收集2009年1月至2010年6月期間我院診斷的19例IHAVM患者資料，其中行MDCT檢查9例，行MRI檢查10例?；仡櫺杂^(guān)察分析其CT和MRI影像表現(xiàn)，特別是增強(qiáng)掃描的強(qiáng)化特征。結(jié)果 ①M(fèi)DCT表現(xiàn)特征： 9例患者病灶平掃均表現(xiàn)為等密度； 增強(qiáng)后動(dòng)脈期呈明顯血管樣或小結(jié)節(jié)樣強(qiáng)化，門(mén)脈期強(qiáng)化持續(xù)，但程度降低，逐漸呈等密度改變。4例出現(xiàn)動(dòng)脈期靜脈分支早顯，6例病變邊緣出現(xiàn)片狀或楔形的動(dòng)脈期一過(guò)性強(qiáng)化。②MRI表現(xiàn)特征： 10例患者病灶動(dòng)脈早期均表現(xiàn)為病灶內(nèi)出現(xiàn)小結(jié)節(jié)樣、團(tuán)狀或條狀強(qiáng)化，動(dòng)脈晚期持續(xù)強(qiáng)化，門(mén)脈期強(qiáng)化程度降低，呈等信號(hào)或稍高信號(hào)改變，平衡期呈等信號(hào)改變。7例病灶邊緣出現(xiàn)動(dòng)脈期異常的一過(guò)性強(qiáng)化區(qū)，5例出現(xiàn)門(mén)靜脈或肝靜脈分支早顯。結(jié)論 多期增強(qiáng)MDCT和MRI掃描均能直觀(guān)、準(zhǔn)確地顯示IHAVM病變的部位、大小、血供等細(xì)節(jié)情況，影像特征明顯，具有較高的診斷價(jià)值。

引用本文： 張羲娥,宋彬,袁放,陳光文,黃子星. 特發(fā)性肝動(dòng)靜脈畸形的影像學(xué)表現(xiàn). 中國(guó)普外基礎(chǔ)與臨床雜志, 2010, 17(11): 1207-1212. doi: 復(fù)制

1. Choi BI, Chung JW, Itai Y, et al. Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT [J]. Abdom Imaging, 1999; 24(4): 340-356.
2. Adaletli I, Kurugoglu S, Kilic F, et al. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn [J]. Pediatr Radiol, 2006; 36(11): 1204-1207.
3. Nishimori A, Okajima H, Okumura K, et al. Living donor liver transplantation as a means of rescuing post-embolization hepatic failure in a patient with idiopathic intrahepatic arteriovenous malformation in the liver [J]. J Hepatobiliary Pancreat Surg, 2009; 16(3): 382-385.
4. 吳春， 姜在波， 李名安, 等. 肝臟特發(fā)性肝動(dòng)脈-門(mén)靜脈畸形1例 [J]. 當(dāng)代醫(yī)學(xué)， 2009; 15（11）: 251-252.
5. Torabi M, Hosseinzadeh K, Federle MP. CT of nonneoplastic hepatic vascular and perfusion disorders [J]. Radiographics, 2008; 28(7): 1967-1982.
6. Choi BI, Lee KH, Han JK, et al. Hepatic arterioportal shunts: dynamic CT and MR features [J]. Korean J Radiol, 2002; 3(1): 1-15.
7. Tian JL, Zhang JS. Hepatic perfusion disorders: etiopathogenesis and related diseases [J]. World J Gastroenterol, 2006; 12(20): 3265-3270.
8. Kim KW, Kim TK, Han JK, et al. Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT [J]． Radiology, 2001; 219(3): 707-711.
9. 歐陽(yáng)墉, 歐陽(yáng)雪暉, 顧蘇賓, 等. 成人肝海綿狀血管瘤并發(fā)動(dòng)靜脈短路的DSA檢查和診斷 [J]． 中華放射學(xué)雜志， 2000; 34(8): 523-527．.
10. 郭啟勇. 實(shí)用放射學(xué) [M]. 北京: 人民衛(wèi)生出版社, 2009: 804-808.
11. Choi CS, Freeny PC. Triphasic helical CT of hepatic focal nodular hyperplasia: incidence of atypical findings [J]. AJR Am J Roentgenol, 1998; 170(2): 391-395.
12. Catalano O, Siani A. Peripheral arterioportal fistula: demonstration with contrast-enhanced sonography [J]． J Ultrasound Med, 2005; 24(7): 1027-1030.
13. Zandrino F, Curone P, Benzi L, et al. Value of an early arteriographic acquisition for evaluating the splanchnic vessels as an adjunct to biphasic CT using a multislice scanner [J]. Eur Radiol, 2003; 13(5): 1072-1079.
14. 張龍江， 宋光義， 包顏明， 等. 肝臟血管解剖和變異的多層螺旋CT血管成像研究 [J]. 中華放射學(xué)雜志, 2005; 39(9): 963-967.
15. Rofsky NM, Lee VS, Laub G, et al. Abdominal MR imaging with a volumetric interpolated breath-hold examination [J]． Radiology, 1999; 212(3): 876-884.
16. 宋彬， 閔鵬秋， 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價(jià)值探討 [J]. 放射學(xué)實(shí)踐, 2006; 21(5): 498-502.
17. 鄔穎華, 宋彬, 徐雋. MRI VIBE序列動(dòng)態(tài)增強(qiáng)對(duì)肝臟局灶性病變的診斷價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(2): 227-232.
  1. 1. Choi BI, Chung JW, Itai Y, et al. Hepatic abnormalities related to blood flow: evaluation with dual-phase helical CT [J]. Abdom Imaging, 1999; 24(4): 340-356.
  2. 2. Adaletli I, Kurugoglu S, Kilic F, et al. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn [J]. Pediatr Radiol, 2006; 36(11): 1204-1207.
  3. 3. Nishimori A, Okajima H, Okumura K, et al. Living donor liver transplantation as a means of rescuing post-embolization hepatic failure in a patient with idiopathic intrahepatic arteriovenous malformation in the liver [J]. J Hepatobiliary Pancreat Surg, 2009; 16(3): 382-385.
  4. 4. 吳春， 姜在波， 李名安, 等. 肝臟特發(fā)性肝動(dòng)脈-門(mén)靜脈畸形1例 [J]. 當(dāng)代醫(yī)學(xué)， 2009; 15（11）: 251-252.
  5. 5. Torabi M, Hosseinzadeh K, Federle MP. CT of nonneoplastic hepatic vascular and perfusion disorders [J]. Radiographics, 2008; 28(7): 1967-1982.
  6. 6. Choi BI, Lee KH, Han JK, et al. Hepatic arterioportal shunts: dynamic CT and MR features [J]. Korean J Radiol, 2002; 3(1): 1-15.
  7. 7. Tian JL, Zhang JS. Hepatic perfusion disorders: etiopathogenesis and related diseases [J]. World J Gastroenterol, 2006; 12(20): 3265-3270.
  8. 8. Kim KW, Kim TK, Han JK, et al. Hepatic hemangiomas with arterioportal shunt: findings at two-phase CT [J]． Radiology, 2001; 219(3): 707-711.
  9. 9. 歐陽(yáng)墉, 歐陽(yáng)雪暉, 顧蘇賓, 等. 成人肝海綿狀血管瘤并發(fā)動(dòng)靜脈短路的DSA檢查和診斷 [J]． 中華放射學(xué)雜志， 2000; 34(8): 523-527．.
  10. 10. 郭啟勇. 實(shí)用放射學(xué) [M]. 北京: 人民衛(wèi)生出版社, 2009: 804-808.
  11. 11. Choi CS, Freeny PC. Triphasic helical CT of hepatic focal nodular hyperplasia: incidence of atypical findings [J]. AJR Am J Roentgenol, 1998; 170(2): 391-395.
  12. 12. Catalano O, Siani A. Peripheral arterioportal fistula: demonstration with contrast-enhanced sonography [J]． J Ultrasound Med, 2005; 24(7): 1027-1030.
  13. 13. Zandrino F, Curone P, Benzi L, et al. Value of an early arteriographic acquisition for evaluating the splanchnic vessels as an adjunct to biphasic CT using a multislice scanner [J]. Eur Radiol, 2003; 13(5): 1072-1079.
  14. 14. 張龍江， 宋光義， 包顏明， 等. 肝臟血管解剖和變異的多層螺旋CT血管成像研究 [J]. 中華放射學(xué)雜志, 2005; 39(9): 963-967.
  15. 15. Rofsky NM, Lee VS, Laub G, et al. Abdominal MR imaging with a volumetric interpolated breath-hold examination [J]． Radiology, 1999; 212(3): 876-884.
  16. 16. 宋彬， 閔鵬秋， 吳苾, 等. 磁共振VIBE序列鑒別胰腺癌與腫塊型慢性胰腺炎的價(jià)值探討 [J]. 放射學(xué)實(shí)踐, 2006; 21(5): 498-502.
  17. 17. 鄔穎華, 宋彬, 徐雋. MRI VIBE序列動(dòng)態(tài)增強(qiáng)對(duì)肝臟局灶性病變的診斷價(jià)值 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2006; 13(2): 227-232.