Nunoi Hiroaki, Hirooka Masashi, Ochi Hironori, Koizumi Yohei, Tokumoto Yoshio, Abe Masanori, Tada Fujimasa, Ikeda Yoshio, Matsuura Bunzo, Tanaka Hiroaki, Tsuda Takaharu, Mochizuki Teruhito, Hiasa Yoichi, Onji Morikazu
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan.
Intern Med. 2013;52(10):1055-9. doi: 10.2169/internalmedicine.52.8848. Epub 2013 May 15.
Portal biliopathy is a morphological abnormality of the biliary ductal and gallbladder wall associated with portal hypertension. A patient with essential thrombocythemia was initially diagnosed with extrahepatic portal vein obstruction (EHPVO). The contrast-enhanced computed tomography (CT) findings were similar to those of cholangiocarcinoma or sclerosing cholangitis. However, color Doppler and contrast-enhanced ultrasound (US) were more specific. The paracholedocheal veins around the bile ducts appeared as beads soon after the injection of contrast medium, followed by linear enhancement of the epicholedochal veins and the gradual enhancement of the whole bile ducts. These findings led to a diagnosis of portal biliopathy, which prevented the patient from having to endure hazardous procedures such as bile duct biopsies. Color Doppler and contrast-enhanced US findings are useful for diagnosing or ruling out portal biliopathy in patients who present with EHPVO.
门静脉性胆管病是一种与门静脉高压相关的胆管和胆囊壁形态学异常。一名原发性血小板增多症患者最初被诊断为肝外门静脉阻塞（EHPVO）。对比增强计算机断层扫描（CT）结果与胆管癌或硬化性胆管炎相似。然而，彩色多普勒和对比增强超声（US）更具特异性。注射造影剂后不久，胆管周围的胆管旁静脉呈串珠状，随后胆管上静脉呈线性增强，整个胆管逐渐增强。这些发现导致诊断为门静脉性胆管病，使患者无需忍受诸如胆管活检等危险操作。彩色多普勒和对比增强超声检查结果有助于诊断或排除表现为EHPVO的患者的门静脉性胆管病。
