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布加综合征经颈静脉肝内门体分流术(TIPS)后良性再生结节的对比增强磁共振血管造影

Contrast-enhanced MR angiography of benign regenerative nodules following TIPS shunt procedure in Budd-Chiari syndrome.

作者信息

Tanju Sumru, Erden Ayşe, Ceyhan Koray, Soygür Işil Türkmen, Bozkaya Hakan, Erden Ilhan

机构信息

Department of Radiology, Ankara University, Ankara, Turkey.

出版信息

Turk J Gastroenterol. 2004 Sep;15(3):173-7.

Abstract

In this report we describe the magnetic resonance (MR) angiographic features of benign hepatic nodules that developed in a patient with Budd-Chiari syndrome, and present the distinguishing features of benign regenerative nodules from hepatocellular cancer. In a 27-year-old woman with chronic Budd-Chiari syndrome, previously non-existing benign nodules developed in the liver parenchyma during the 10-month period following transjugular intrahepatic portosystemic (TIPS) shunt placement. The liver had been examined with gray-scale and Doppler sonography in addition to the MR imaging and MR angiography. On MR angiography, more hepatic nodules became visible in the portal venous phase compared to that of the arterial phase. Delayed washout of contrast medium in nodules was considered to be due to stasis in hepatic sinusoids. Hypervascularization, appearance after portosystemic shunt creation, multiplicity, small size ( <=2 cm in diameter in our patient), presence of peripheral rim, and high signal intensity on T1-weighted images are important imaging features of benign hepatic nodules that develop in patients with Budd-Chiari syndrome.

摘要

在本报告中,我们描述了布加综合征患者肝脏中出现的良性肝结节的磁共振(MR)血管造影特征,并介绍了良性再生结节与肝细胞癌的鉴别特征。一名27岁患有慢性布加综合征的女性患者,在经颈静脉肝内门体分流术(TIPS)放置后的10个月期间,肝脏实质内出现了之前不存在的良性结节。除了MR成像和MR血管造影外,还对肝脏进行了灰阶和多普勒超声检查。在MR血管造影中,与动脉期相比,门静脉期可见更多的肝结节。结节内造影剂延迟洗脱被认为是由于肝血窦内血流淤滞所致。高血管化、门体分流术后出现、多发、体积小(我们的患者直径≤2 cm)、周边有边缘以及T1加权图像上的高信号强度是布加综合征患者肝脏中出现的良性肝结节的重要影像学特征。

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