Neesse A, Huth J, Heumann T, Michl P, Steinkamp M, Gress T M, Görg C, Kunsch S
Gastroenterology, Endocrinology and Metabolism, University of Marburg, Marburg.
Ultraschall Med. 2008 Dec;29(6):633-8. doi: 10.1055/s-2008-1027861. Epub 2008 Oct 28.
To determine the prevalence of echo-rich and echo-poor periportal cuffing in patients from a German tertiary referral hospital and correlate ultrasonographic findings with clinical data.
From April 2002 till April 2008 about 10 500 abdominal examinations were performed by a single physician in our interdisciplinary ultrasound unit. During this time, n = 100 patients (62 male/ 38 female) with periportal cuffing of the liver were detected qualifying for the retrospective study design. Echomorphology of periportal cuffing was evaluated and clinical diagnoses of the underlying diseases were clustered in four main groups: Liver diseases, haematological diseases, bowel diseases and others. Furthermore, liver function tests and body mass index were determined.
The mean age of the patients was 57.06 years (SD +/- 19.47). Mean body-mass-index was 24.76 kg/m (2) (SD +/- 4.28). Periportal cuffing was echo-poor in n = 9 (9 %) and echo-rich in n = 91 (91 %). Echo-poor periportal cuffing was significantly more often associated with malignant diseases as compared to echo-rich periportal cuffing (78 vs. 36 %) (p < 0.025). Liver diseases (n = 33) were malign n = 10 (10 %), autoimmune n = 8 (8 %), infectious n = 8 (8 %) and cholestatic n = 7 (7 %). Bowel diseases (n = 34) originated from the upper gastrointestinal tract n = 7 (7 %), lower gastrointestinal tract n = 21 (21 %) and the pancreas n = 6 (6 %). Haematological disorders (n = 15, 15 %) were chronic myeloproliferative n = 2 (2 %), lymphoma n = 8 (8 %), leukemia n = 4 (4 %) and miscellaneous n = 1 (1 %). Other diseases accounted for 18 (18 %) of cases. Aspartat-aminotrasferase (AST) and alanin-aminotransferase (ALT) were elevated in 39 patients (40 %) and 34 patients (35 %), respectively. Total bilirubin was elevated in 35 patients (36 %). Alkaline phosphatase (AP) was detected above normal range in 49 patients (50 %) whereas g-glutamyl-transferase was elevated in 58 patients (59 %).
Periportal cuffing of the liver is an extremely rare ultrasonographic phenomenon with a prevalence of approximately 0.95 % in our unit. Echo-rich periportal cuffing occurs more frequently than echo-poor periportal cuffing. The majority of echo-poor periportal cuffing is associated with malignant disorders, in particular haematological diseases, whereas echo-rich periportal cuffing is most frequently seen in inflammatory bowel disease patients.
确定一家德国三级转诊医院患者中高回声和低回声肝门周围套袖征的患病率，并将超声检查结果与临床数据相关联。
2002年4月至2008年4月期间，我们跨学科超声科室的一名医生进行了约10500次腹部检查。在此期间，共检测到n = 100例肝门周围套袖征患者（62例男性/38例女性），符合回顾性研究设计要求。评估了肝门周围套袖征的回声形态，并将潜在疾病的临床诊断分为四个主要组：肝脏疾病、血液系统疾病、肠道疾病和其他疾病。此外，还测定了肝功能试验和体重指数。
患者的平均年龄为57.06岁（标准差±19.47）。平均体重指数为24.76kg/m²（标准差±4.28）。9例（9%）肝门周围套袖征为低回声，91例（91%）为高回声。与高回声肝门周围套袖征相比，低回声肝门周围套袖征与恶性疾病的相关性明显更高（78%对36%）（p < 0.025）。肝脏疾病（n = 33）中，恶性疾病10例（10%），自身免疫性疾病8例（8%），感染性疾病8例（8%），胆汁淤积性疾病7例（7%）。肠道疾病（n = 34）起源于上消化道7例（7%），下消化道21例（21%），胰腺6例（6%）。血液系统疾病（n = 15，15%）中，慢性骨髓增殖性疾病2例（2%），淋巴瘤8例（8%），白血病4例（4%），其他1例（1%）。其他疾病占病例的18例（18%）。39例（40%）患者天门冬氨酸转氨酶（AST）升高，34例（35%）患者丙氨酸转氨酶（ALT）升高。35例（36%）患者总胆红素升高。49例（50%）患者碱性磷酸酶（AP）检测高于正常范围，而58例（59%）患者γ-谷氨酰转移酶升高。
肝门周围套袖征是一种极其罕见的超声现象，在我们科室的患病率约为0.95%。高回声肝门周围套袖征比低回声肝门周围套袖征更常见。大多数低回声肝门周围套袖征与恶性疾病相关，尤其是血液系统疾病，而高回声肝门周围套袖征最常见于炎症性肠病患者。
