Koc Zafer, Oguzkurt Levent, Ulusan Serife
Department of Radiology, Başkent University Faculty of Medicine, Dadaloğlu Mah., Serin Evler 39 Sok. No 6, Yüreğir, 01250 Adana, Turkey.
AJR Am J Roentgenol. 2007 Nov;189(5):1023-30. doi: 10.2214/AJR.07.2121.
The aims of this study were to present the prevalence, imaging and clinical findings, and possible causes of portal venous system aneurysms.
From 1998 to 2006, a total of 38 portal venous system aneurysms identified in 25 patients were retrospectively reviewed. The data of seven patients diagnosed using color Doppler sonography or CT before March 2004 were not consecutive, but the data recorded thereafter comprised the analysis of 4,186 consecutive patients who underwent routine abdominal MDCT. The patients were 14 men and 11 women (mean age -/+ SD, 53 -/+ 17 years).
The prevalence of portal venous system aneurysm among 4,186 consecutive patients was 0.43%. There were no differences with respect to patient age, patient sex, and intrahepatic or extrahepatic location of aneurysm between those with and those without portal venous system aneurysm. Seven of the 25 patients with portal venous system aneurysm were symptomatic because of portal vein thrombosis, and six of them had recurrence. These patients had significantly larger aneurysms than those without symptoms. Four of those seven symptomatic patients evaluated for thrombophilia had an underlying defect. Other associated findings were splenomegaly (n = 16), portal hypertension (n = 8), cirrhosis (n = 3), psoriasis (n = 2), portal vein variation (n = 1), chronic pancreatitis (n = 1), and cutis laxa (n =1).
Portal venous system aneurysms were rare in our study group but occurred more frequently than previously thought. All thrombosed aneurysms, most with a recurrence, were symptomatic and larger in patients with symptoms of portal venous system aneurysm than in those without symptoms. There were no differences among patients with portal venous system aneurysm and those without portal venous system aneurysm with respect to patient age and patient sex. Among those with aneurysms, there was no difference between subjects with intrahepatic versus extrahepatic aneurysms. A thrombophilic defect probably played a role in development of thrombosis in the portal venous system aneurysm.
本研究旨在阐述门静脉系统动脉瘤的患病率、影像学及临床特征，以及其可能的病因。
回顾性分析1998年至2006年间25例患者中确诊的38例门静脉系统动脉瘤。2004年3月前7例经彩色多普勒超声或CT诊断的患者数据不连续，之后记录的数据包括对4186例接受常规腹部MDCT检查的连续患者的分析。患者中男性14例，女性11例（平均年龄±标准差，53±17岁）。
在4186例连续患者中，门静脉系统动脉瘤的患病率为0.43%。门静脉系统有动脉瘤和无动脉瘤的患者在年龄、性别以及动脉瘤位于肝内或肝外方面无差异。25例门静脉系统动脉瘤患者中有7例因门静脉血栓形成出现症状，其中6例复发。这些患者的动脉瘤明显大于无症状患者。在接受血栓形成倾向评估的7例有症状患者中，4例有潜在缺陷。其他相关表现包括脾肿大（n = 16）、门静脉高压（n = 8）、肝硬化（n = 3）、银屑病（n = 2）、门静脉变异（n = 1）、慢性胰腺炎（n = 1）和皮肤松弛症（n = 1）。
在我们的研究组中，门静脉系统动脉瘤较为罕见，但发生率比之前认为的更高。所有血栓形成的动脉瘤大多复发，有门静脉系统动脉瘤症状的患者有症状且动脉瘤比无症状患者更大。门静脉系统有动脉瘤和无动脉瘤的患者在年龄和性别方面无差异。在有动脉瘤的患者中，肝内动脉瘤与肝外动脉瘤患者之间无差异。血栓形成倾向缺陷可能在门静脉系统动脉瘤血栓形成过程中起作用。
