Tublin Mitchell E, Towbin Alexander J, Federle Michael P, Nalesnik Michael A
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Dig Dis Sci. 2008 Oct;53(10):2784-8. doi: 10.1007/s10620-008-0201-6. Epub 2008 Feb 14.
The macroscopic appearance of the liver after primary portal vein thrombosis often mimics cirrhosis, despite the absence of bridging fibrosis at histology. The purpose of this study was to describe unique morphologic changes of the liver after portal venous thrombosis. A retrospective review was performed to find patients with portal vein thrombosis and a corresponding noncirrhotic liver biopsy. The CT appearance of the liver was then evaluated, and the liver was categorized as having either peripheral or central hepatic atrophy. Of 15 patients included in this study, 12 had peripheral atrophy of the liver, while the remaining three had central atrophy. We concluded that maintenance of central portal venous blood flow and resultant relative peripheral atrophy of the liver may account for a distinctive rounded configuration of the liver after acute portal vein thrombosis. Awareness of this appearance after primary portal vein thrombosis may prevent an erroneous diagnosis of cirrhosis.
尽管在组织学上没有桥接纤维化，但原发性门静脉血栓形成后肝脏的宏观外观常类似肝硬化。本研究的目的是描述门静脉血栓形成后肝脏独特的形态学变化。进行了一项回顾性研究，以寻找患有门静脉血栓形成且有相应非肝硬化肝脏活检的患者。然后评估肝脏的CT表现，并将肝脏分类为具有外周性或中央性肝萎缩。在本研究纳入的15例患者中，12例有肝脏外周萎缩，其余3例有中央萎缩。我们得出结论，中央门静脉血流的维持以及由此导致的肝脏相对外周萎缩可能是急性门静脉血栓形成后肝脏呈现独特圆形形态的原因。认识到原发性门静脉血栓形成后的这种表现可能会避免对肝硬化的错误诊断。
