Department of Radiology, Faculty of Medicine, Ankara University, Sihhiye/Ankara, Turkey.
Eur J Gastroenterol Hepatol. 2009 Jul;21(7):776-80. doi: 10.1097/MEG.0b013e328305b9f3.
The aim of this study is to present the contrast enhanced magnetic resonance angiography findings of hepatic venous outflow obstruction in patients in whom surgery had been performed for hepatic hydatidosis. No patient history of parasitic hepatic venous invasion or earlier hepatic venous outflow obstruction is present.
Four men and three women with a history of hydatid cyst surgery underwent contrast enhanced magnetic resonance angiography between April 2001 and June 2006. The mean age was 37.7 years. The mean time duration between the last date of surgery and the date of magnetic resonance angiography imaging was 65.5 months. The site of the hydatid cyst was the right lobe in two patients, the medial segment of the left lobe in two patients, the liver dome in two patients, and the conjunction of the right lobe anterior-left lobe medial segments in one patient. One patient had undergone total and one patient had undergone partial lobectomy, and cystectomy was performed in five patients.
On magnetic resonance angiograms, nonvisualization or stenosis of the hepatic veins was detected in all cases. In one patient thrombosis and in another patient severe stenosis of the inferior vena cava were associated. The portal hilum was displaced anterosuperiorly in five patients. Intrahepatic collaterals were present in six patients and extrahepatic collaterals were seen in three. Associated thrombosis in the left portal vein was found in two patients.
We conclude that patients with complicated hydatid cysts and who have had postoperative complications should be checked not only for recurrence or abscess formation, but also for vascular changes. magnetic resonance angiography is a useful alternative imaging technique and can provide useful information at one session within several minutes in patients who had undergone surgery for hydatid cyst of the liver.
本研究旨在展示已接受肝包虫病手术治疗的患者肝静脉流出道梗阻的增强磁共振血管造影表现。这些患者均无寄生虫性肝静脉侵犯或更早的肝静脉流出道梗阻病史。
2001 年 4 月至 2006 年 6 月期间，4 名男性和 3 名女性接受了增强磁共振血管造影检查，这些患者均有肝包虫囊肿手术史。平均年龄为 37.7 岁。末次手术日期与磁共振血管造影成像日期之间的平均时间间隔为 65.5 个月。肝包虫囊肿的部位：2 例位于右叶，2 例位于左叶内侧段，2 例位于肝顶，1 例位于右叶前段与左叶内侧段交界处。1 例患者行全叶切除术，1 例患者行部分肝叶切除术，5 例患者行肝包虫囊肿切除术。
磁共振血管造影显示所有患者均存在肝静脉不显影或狭窄。1 例患者合并血栓形成，另 1 例患者下腔静脉严重狭窄。5 例患者门静脉干向前上移位。6 例患者存在肝内侧支循环，3 例患者存在肝外侧支循环。2 例患者发现左门静脉血栓形成。
我们认为，患有复杂肝包虫病且术后出现并发症的患者，不仅应检查是否有复发或脓肿形成，还应检查血管变化。磁共振血管造影是一种有用的替代成像技术，可为已接受肝包虫病手术治疗的患者在数分钟内的一次检查提供有用的信息。
