Yamada M, Ishida H, Komatsuda T, Furukawa K, Yagisawa H, Ohno H, Katsuura Y, Suganuma K
Center of Diagnostic Ultrasound, Akita Red Cross Hospital, 222-1, Saruta Kamikitade Akita, Japan.
Abdom Imaging. 2006 Nov-Dec;31(6):701-5. doi: 10.1007/s00261-005-8006-y. Epub 2006 Feb 7.
Despite the semi-routine use of color Doppler sonography for evaluating portal circulation abnormalities, there is a relative paucity of detailed color Doppler findings of portal systemic (P-S) shunt through the renal vein (P-SR shunt).
We reviewed the color Doppler findings of 18 patients with P-SR shunt to determine its clinical significance and appropriate scanning techniques for diagnosing accurately P-SR shunt.
The splenorenal shunt was imaged as a highly tortuous vessel at the splenic hilum, which then coursed backward behind the spleen. Splenic vein flow was reversed or very slow. The gastrorenal shunt originated from the splenic vein, coursed backward, and joined the left renal vein. Flow direction in the splenic vein was always hepatopetal. The P-S shunt through the right renal vein originated from duodenal or jejunal varices, coursed posterolaterally, and joined the right renal vein at the renal hilum.
Familiarity with these color Doppler findings will help increase the diagnostic confidence of P-SR shunt by color Doppler sonography.
尽管彩色多普勒超声已半常规用于评估门静脉循环异常，但关于经肾静脉的门体分流（P-SR分流）的详细彩色多普勒表现相对较少。
我们回顾了18例P-SR分流患者的彩色多普勒表现，以确定其临床意义及准确诊断P-SR分流的合适扫描技术。
脾肾分流在脾门处显示为高度迂曲的血管，然后在脾后方向后走行。脾静脉血流反向或非常缓慢。胃肾分流起源于脾静脉，向后走行，汇入左肾静脉。脾静脉内血流方向始终朝向肝脏。经右肾静脉的P-S分流起源于十二指肠或空肠静脉曲张，向后外侧走行，在肾门处汇入右肾静脉。
熟悉这些彩色多普勒表现将有助于提高彩色多普勒超声诊断P-SR分流的信心。
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