Lee M G, Cho K S, Auh Y H, Baek S Y, Kim M H, Yu E S
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Imaging. 1992 Oct-Dec;16(4):234-8. doi: 10.1016/0899-7071(92)90003-r.
Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaging), multiple small color Doppler signals were observed in the vascular radicles within the dilated bile ducts or in the center of the lumen apart from the vascular radicles, as well as in other well-known sonographic findings such as bile duct dilatations and bilary calculi. Doppler frequency spectral analysis confirmed all these color signals as arterial in origin in all patients, revealing pulsatile wave patterns. In spite of the fact that portal venous radicles have been well described on conventional sonograms or computed tomography (CT), continuous wave patterns of venous flow on spectral analysis were not detected in all patients. Identification of such less emphasized arterial flow may add another clue in the diagnosis and pathogenesis of this rare disease entity. In conclusion, color Doppler signals of arterial wave pattern within the dilated bile ducts are another helpful diagnostic criteria in previously reported sonographic findings, and these color signals are easily depicted on sonograms with color mapping.
本文报告了3例患有先天性肝内胆管扩张（卡罗利病）的兄弟姐妹。所有3例患者的胆管病理均与先天性肝纤维化和多囊肾病相关。在彩色多普勒成像（CD成像）中，在扩张胆管内的血管分支中或在远离血管分支的管腔中心观察到多个小的彩色多普勒信号，以及在其他众所周知的超声检查结果中，如胆管扩张和胆石症。多普勒频谱分析证实所有这些彩色信号在所有患者中均起源于动脉，显示出搏动性波形。尽管在传统超声检查或计算机断层扫描（CT）中门静脉分支已被详细描述，但并非所有患者在频谱分析中均检测到静脉血流的连续波形。识别这种较少被强调的动脉血流可能为这种罕见疾病实体的诊断和发病机制提供另一条线索。总之，扩张胆管内动脉波形的彩色多普勒信号是先前报道的超声检查结果中的另一个有用的诊断标准，并且这些彩色信号在具有彩色映射的超声图上很容易描绘。
