Perronne Laetitia, Dohan Anthony, Bazeries Paul, Guerrache Youcef, Fohlen Audrey, Rousset Pascal, Aubé Christophe, Laurent Valérie, Morel Olivier, Boudiaf Mourad, Hoeffel Christine, Soyer Philippe
Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France.
Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010, Paris, France.
Abdom Imaging. 2015 Oct;40(7):2839-49. doi: 10.1007/s00261-015-0481-1.
HELLP syndrome, which consists of hemolysis, elevated liver enzymes, and low platelet count is an unusual complication of pregnancy that is observed in only 10% to 15% of women with preeclampsia. Hepatic involvement in HELLP syndrome may present with various imaging features depending on the specific condition that includes nonspecific abnormalities such as perihepatic free fluid, hepatic steatosis, liver enlargement, and periportal halo that may precede more severe conditions such as hepatic hematoma and hepatic rupture with hemoperitoneum. Maternal clinical symptoms may be nonspecific and easily mistaken for a variety of other conditions that should be recognized. Because hepatic hematoma occurring in association with preeclampsia and HELLP syndrome is a potentially life-threatening complication, prompt depiction is critical and may help reduce morbidity and mortality. This review provides an update on demographics, risk factors, pathophysiology, and clinical features of hepatic complications due to HELLP syndrome along with a special emphasis on the imaging features of these uncommon conditions.
HELLP综合征包括溶血、肝酶升高和血小板计数降低，是妊娠期一种罕见的并发症，仅在10%至15%的子痫前期女性中出现。HELLP综合征的肝脏受累可能表现出各种影像学特征，具体取决于特定情况，包括非特异性异常，如肝周游离液体、肝脂肪变性、肝脏肿大和门静脉周围晕圈，这些可能先于更严重的情况出现，如肝血肿和伴有腹腔积血的肝破裂。产妇的临床症状可能不具有特异性，很容易与其他各种应予以识别的病症相混淆。由于子痫前期和HELLP综合征相关的肝血肿是一种潜在的危及生命的并发症，及时发现至关重要，可能有助于降低发病率和死亡率。本综述提供了HELLP综合征所致肝脏并发症的人口统计学、危险因素、病理生理学和临床特征的最新信息，并特别强调了这些罕见病症的影像学特征。
