Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.
Department of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.
Ultrasound Q. 2024 Sep 13;40(4). doi: 10.1097/RUQ.0000000000000694. eCollection 2024 Dec 1.
Sonographic detection of mobile echogenic foci within the main portal vein and its branches or within the liver parenchyma extending along the portal triads to the periphery of the liver is an alarming finding that has been associated with portal venous gas in the setting of bowel ischemia. Ultrasound-enhancing agents (UEAs) have been widely utilized in abdominal ultrasound for evaluation of organ neoplasms and vascular patency as well as in echocardiography for the evaluation of cardiac function. The appearance of UEAs on abdominal ultrasound can resemble gas like that seen in the portal venous system and liver in patients with bowel ischemia; therefore, UEA residuals should always be a part of the differential diagnosis of echogenic foci when seen on abdominal ultrasounds with preceding recent UEA administration. In this observational study, we present a series of cases with suspected portal venous gas suspicious for bowel ischemia that turned out to be a result of residual or persistent UEA from the recent contrast-enhanced echocardiography. Discussion of this phenomenon and its potential explanation is provided.
超声检测到门静脉主干及其分支内或肝实质内沿门三联向肝脏周边延伸的移动性强回声灶是一种警示性发现，与肠缺血时门静脉积气有关。超声增强剂（UEA）已广泛应用于腹部超声评估器官肿瘤和血管通畅性，以及超声心动图评估心功能。腹部超声上 UEA 的出现类似于肠缺血患者门静脉系统和肝脏中的气体；因此，在最近使用 UEA 后进行腹部超声检查时，如果发现强回声灶，UEA 残留应始终是鉴别诊断的一部分。在这项观察性研究中，我们展示了一系列疑似肠缺血的可疑门静脉积气的病例，结果是最近增强超声心动图后的残留或持续 UEA 所致。我们对这种现象及其潜在解释进行了讨论。
