Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.
Abdom Radiol (NY). 2024 Aug;49(8):2756-2769. doi: 10.1007/s00261-024-04328-2. Epub 2024 May 12.
Portal venous gas on abdominal ultrasound classically represents an indirect indicator of bowel ischemia, a critical condition which poses a high patient mortality and therefore warrants emergent corrective action. While the classic appearance of portal venous gas on ultrasound is well-described in the literature, the characteristic descriptors are nonspecific and may actually represent other less emergent mimics. Therefore, while radiologists should remain vigilant for the detection of findings corresponding to portal venous gas, they should also be aware of similar-appearing entities in order to provide the most accurate diagnosis. This pictorial essay will open with imaging examples of true portal venous gas attributable to bowel ischemia and describe the classic features which should alert radiologists to this specific diagnosis. Subsequently, this pictorial essay will provide imaging examples of other various other clinical entities which on ultrasound may share similar imaging characteristics. An important objective of this pictorial essay is to highlight distinguishing imaging features along with specific clinical circumstances for each pathological entity which can direct radiologists into identifying the correct diagnosis.
腹部超声上的门静脉积气经典地代表了肠缺血的间接指标，这是一种严重的情况，患者死亡率很高，因此需要紧急采取纠正措施。虽然文献中很好地描述了超声上门静脉积气的典型表现，但特征性描述并不特异，实际上可能代表其他不太紧急的类似情况。因此，虽然放射科医生应保持警惕，以发现与门静脉积气相对应的发现，但他们也应该了解类似的表现形式，以便提供最准确的诊断。本文将首先展示归因于肠缺血的真正门静脉积气的影像学示例，并描述应提醒放射科医生做出这一特定诊断的典型特征。随后，本文将提供其他各种临床实体的影像学示例，这些实体在超声上可能具有相似的影像学特征。本文的一个重要目标是突出每个病理实体的鉴别影像学特征以及特定的临床情况，这可以指导放射科医生识别正确的诊断。
