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先天性肝内门体分流犬的肝内静脉侧支与局灶性分流或肝静脉狭窄有关。

Intrahepatic venous collaterals in dogs with congenital intrahepatic portosystemic shunts are associated with focal shunt or hepatic vein narrowing.

机构信息

The Animal Medical Center, New York, New York, USA.

出版信息

Vet Radiol Ultrasound. 2022 Jan;63(1):64-72. doi: 10.1111/vru.13030. Epub 2021 Oct 12.

Abstract

Dogs with congenital intrahepatic portosystemic shunts (IHPSS) occasionally have multiple smaller intrahepatic, tortuous blood vessels surrounding the primary shunt. This study was a retrospective, observational design that was also descriptive and anatomic in nature. Objectives were to characterize vascular morphology in IHPSS dogs presenting with intrahepatic venous collaterals (IVCs) relative to IHPSS dogs without IVCs, and to propose reasons for IVC development. The authors hypothesized that (a) IVCs develop secondary to flow resistance around a focal area of a shunt or draining hepatic vein narrowing and (b) the presence of IVC is associated with portal vessel development before intervention. Anonymized CT angiograms (CTA) and fluoroscopic portovenograms (FPV) of dogs with IHPSS were evaluated for the presence of IVCs, focal narrowing within the IHPSS, and intrahepatic portal vessels >5 mm long. Eleven of 47 (23%) dogs had IVCs identified. IVCs were significantly associated with focal narrowing in the shunt or draining hepatic vein on CTA (P = 0.039) and FPV (P = 0.021). IVCs were not associated with the presence of intrahepatic portal branches >5 mm long on portovenography (P = 0.42) or CTA (P = 0.49). Focal narrowing in the shunt (circumferential soft tissue narrowing >20% of the shunt diameter) was significantly associated with intrahepatic portal branches >5 mm long on both modalities (P < 0.001). IVCs are associated with focal narrowing of the shunt or draining hepatic vein in dogs with IHPSS. IVC should be distinguished from other conditions when evaluating a CTA for canine IHPSS.

摘要

患有先天性肝内门体分流(IHPSS)的狗偶尔会有多个较小的、围绕主要分流的肝内扭曲血管。本研究为回顾性、观察性设计,具有描述性和解剖学性质。目的是描述具有肝内静脉侧支(IVC)的 IHPSS 犬与不具有 IVC 的 IHPSS 犬的血管形态,并提出 IVC 发展的原因。作者假设:(a) IVC 是由于分流或引流肝静脉狭窄处的局部区域的血流阻力而发展的;(b) IVC 的存在与介入前门静脉血管的发育有关。对患有 IHPSS 的犬的 CT 血管造影(CTA)和荧光透视门静脉造影(FPV)进行评估,以确定是否存在 IVC、IHPSS 内的局灶性狭窄以及>5mm 长的肝内门静脉血管。47 只狗中有 11 只(23%)被发现有 IVC。IVC 与 CTA(P=0.039)和 FPV(P=0.021)上分流或引流肝静脉的局灶性狭窄显著相关。IVC 与门静脉造影(P=0.42)或 CTA(P=0.49)上>5mm 长的肝内门静脉分支的存在无关。分流的局灶性狭窄(环形软组织狭窄>分流直径的 20%)与两种方式上>5mm 长的肝内门静脉分支显著相关(P<0.001)。IVC 与 IHPSS 犬分流或引流肝静脉的局灶性狭窄相关。在评估犬 IHPSS 的 CTA 时,应将 IVC 与其他情况区分开来。

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