Zeitoun Delphine, Brancatelli Giuseppe, Colombat Magali, Federle Michael P, Valla Dominique, Wu Tong, Degott Claude, Vilgrain Valérie
Department of Radiology, Hopital Beaujon, Clichy, France.
Radiology. 2004 Apr;231(1):109-16. doi: 10.1148/radiol.2311030108. Epub 2004 Feb 27.
To evaluate the computed tomographic (CT) findings in adult patients with pathologically proved congenital hepatic fibrosis.
This was a retrospective review of congenital hepatic fibrosis cases identified at two institutions over the course of 8 years. Eight men and 10 women with an age range of 22-72 years (mean age, 39 years) were included. Contrast material-enhanced and unenhanced CT scans were obtained through the liver in all patients. Two radiologists evaluated size of and morphologic findings (atrophy or hypertrophy localized according to hepatic segments) in the liver; increased diameter or number of hepatic arteries at the hilum; presence of hepatic nodules, varices, spontaneous splenorenal shunts, and splenomegaly; and association with other hepatic ductal plate malformations and renal abnormalities.
Sixteen patients had morphologic abnormalities in the liver, 15 had splenomegaly (three underwent splenectomy for portal hypertension), and 14 had varices or spontaneous splenorenal shunts. An enlarged hepatic artery and a tangle of abnormally enlarged arterial vessels were identified in five and four patients, respectively, and four of these nine patients had large benign regenerative nodules. Ten patients had renal abnormalities and nine had an associated ductal plate malformation.
This retrospective study shows that certain findings (ie, liver morphologic and associated ductal plate abnormalities, varices, splenomegaly, and renal abnormalities) are frequently observed in combination in patients with congenital hepatic fibrosis.
评估经病理证实的成人先天性肝纤维化患者的计算机断层扫描(CT)表现。
这是一项对8年间在两家机构确诊的先天性肝纤维化病例的回顾性研究。纳入了8名男性和10名女性,年龄范围为22 - 72岁(平均年龄39岁)。所有患者均进行了肝脏的对比增强CT扫描和非增强CT扫描。两名放射科医生评估了肝脏的大小和形态学表现(根据肝段定位的萎缩或肥大);肝门处肝动脉直径增加或数量增多;肝结节、静脉曲张、自发性脾肾分流和脾肿大的存在情况;以及与其他肝内胆管板畸形和肾脏异常的关联。
16例患者肝脏存在形态学异常,15例有脾肿大(3例因门静脉高压接受了脾切除术),14例有静脉曲张或自发性脾肾分流。分别在5例和4例患者中发现肝动脉增粗以及一团异常增粗的动脉血管,这9例患者中有4例有大的良性再生结节。10例患者有肾脏异常,9例有相关的胆管板畸形。
这项回顾性研究表明,在先天性肝纤维化患者中,某些表现(即肝脏形态学和相关胆管板异常、静脉曲张、脾肿大和肾脏异常)经常同时出现。