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先天性肝外门体分流:超声、计算机断层扫描和磁共振成像的表现谱

Congenital Extrahepatic Portosystemic Shunts: Spectrum of Findings on Ultrasound, Computed Tomography, and Magnetic Resonance Imaging.

作者信息

Gupta Pankaj, Sinha Anindita, Sodhi Kushaljit Singh, Lal Anupam, Debi Uma, Thapa Babu R, Khandelwal Niranjan

机构信息

Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.

Pediatric Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.

出版信息

Radiol Res Pract. 2015;2015:181958. doi: 10.1155/2015/181958. Epub 2015 Dec 13.

DOI:10.1155/2015/181958
PMID:26858845
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4691495/
Abstract

Congenital extrahepatic portosystemic shunt (CEPS) is a rare disorder characterised by partial or complete diversion of portomesenteric blood into systemic veins via congenital shunts. Type I is characterised by complete lack of intrahepatic portal venous blood flow due to an end to side fistula between main portal vein and the inferior vena cava. Type II on the other hand is characterised by partial preservation of portal blood supply to liver and side to side fistula between main portal vein or its branches and mesenteric, splenic, gastric, and systemic veins. The presentation of these patients is variable. Focal liver lesions, most commonly nodular regenerative hyperplasia, are an important clue to the underlying condition. This pictorial essay covers imaging characteristics in abdominopelvic region.

摘要

先天性肝外门体分流(CEPS)是一种罕见的疾病,其特征是门静脉肠系膜血液通过先天性分流部分或完全分流至体静脉。I型的特征是由于门静脉主干与下腔静脉之间的端侧瘘导致肝内门静脉血流完全缺失。另一方面,II型的特征是肝脏的门静脉血供部分保留,且门静脉主干或其分支与肠系膜静脉、脾静脉、胃静脉和体静脉之间存在侧侧瘘。这些患者的临床表现各异。局灶性肝病变,最常见的是结节性再生性增生,是潜在病情的重要线索。这篇图文并茂的文章涵盖了腹盆腔区域的影像学特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/3e00986ca9b3/RRP2015-181958.011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/4d7f87467458/RRP2015-181958.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c1bed6dff53e/RRP2015-181958.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c5c40c91c22a/RRP2015-181958.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/331aed4f5336/RRP2015-181958.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/259227043330/RRP2015-181958.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/047c61614300/RRP2015-181958.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/2f35c96cf369/RRP2015-181958.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/3dbbf052ed1b/RRP2015-181958.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/e886180c103f/RRP2015-181958.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c27cb9f2aaca/RRP2015-181958.010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/3e00986ca9b3/RRP2015-181958.011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/4d7f87467458/RRP2015-181958.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c1bed6dff53e/RRP2015-181958.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c5c40c91c22a/RRP2015-181958.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/331aed4f5336/RRP2015-181958.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/259227043330/RRP2015-181958.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/047c61614300/RRP2015-181958.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/2f35c96cf369/RRP2015-181958.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/3dbbf052ed1b/RRP2015-181958.008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/e886180c103f/RRP2015-181958.009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/c27cb9f2aaca/RRP2015-181958.010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c0b/4691495/3e00986ca9b3/RRP2015-181958.011.jpg

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本文引用的文献

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Agenesis of the venous duct: two cases of extrahepatic drainage of the umbilical vein and extrahepatic portosystemic shunt with a review of the literature.静脉导管缺如:两例脐静脉肝外引流及肝外门体分流并文献复习
Cardiol Young. 2015 Feb;25(2):208-17. doi: 10.1017/S1047951114000729. Epub 2014 May 22.
2
Congenital portosystemic shunts in children: a new anatomical classification correlated with surgical strategy.儿童先天性门体分流:一种新的解剖学分类与手术策略相关。
Ann Surg. 2014 Jul;260(1):188-98. doi: 10.1097/SLA.0000000000000266.
3
Congenital portosystemic shunts in children: recognition, evaluation, and management.
儿童先天性门体分流:识别、评估与管理。
Semin Liver Dis. 2012 Nov;32(4):273-87. doi: 10.1055/s-0032-1329896. Epub 2013 Feb 8.
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Nodular regenerative hyperplasia of the liver: coral atoll-like lesions on ultrasound are characteristic in predisposed patients.肝脏结节性再生性增生:超声显示珊瑚环样病变在易患患者中具有特征性。
Br J Radiol. 2011 Jul;84(1003):e129-34. doi: 10.1259/bjr/17975057.
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Clinical and radiologic manifestations of congenital extrahepatic portosystemic shunts: a comprehensive review.先天性肝外门体分流的临床和放射学表现:全面综述。
Radiographics. 2011 May-Jun;31(3):707-22. doi: 10.1148/rg.313105070.
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Management and classification of type II congenital portosystemic shunts.II 型先天性门体分流的管理和分类。
J Pediatr Surg. 2011 Feb;46(2):308-14. doi: 10.1016/j.jpedsurg.2010.11.009.
7
Congenital portosystemic shunts: imaging findings and clinical presentations in 11 patients.先天性门体分流:11 例患者的影像学表现和临床表现。
Eur J Radiol. 2011 Nov;80(2):175-81. doi: 10.1016/j.ejrad.2009.12.031. Epub 2010 Jan 27.
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Insight into congenital absence of the portal vein: is it rare?先天性门静脉缺如的深入探讨:它罕见吗?
World J Gastroenterol. 2008 Oct 21;14(39):5969-79. doi: 10.3748/wjg.14.5969.
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The clinical anatomy of congenital portosystemic venous shunts.先天性门体静脉分流的临床解剖学
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Eur J Pediatr Surg. 2007 Aug;17(4):292-4. doi: 10.1055/s-2007-965448.