Rosselli Matteo, Popescu Alina, Bende Felix, Al Refaie Antonella, Lim Adrian
Department of Internal Medicine, San Giuseppe Hospital, USL Toscana Centro, 50053 Empoli, Italy.
Division of Medicine, Institute for Liver and Digestive Health, University College London, London NW3 2PF, UK.
Medicina (Kaunas). 2024 Nov 27;60(12):1955. doi: 10.3390/medicina60121955.
Vascular liver diseases (VLDs) include different pathological conditions that affect the liver vasculature at the level of the portal venous system, hepatic artery, or venous outflow system. Although serological investigations and sometimes histology might be required to clarify the underlying diagnosis, imaging has a crucial role in highlighting liver inflow or outflow obstructions and their potential causes. Cross-sectional imaging provides a panoramic view of liver vascular anatomy and parenchymal patterns of enhancement, making it extremely useful for the diagnosis and follow-up of VLDs. Nevertheless, multiparametric ultrasound analysis provides information useful for differentiating acute from chronic portal vein thrombosis, distinguishing neoplastic invasion of the portal vein from bland thrombus, and clarifying the causes of venous outflow obstruction. Color Doppler analysis measures blood flow velocity and direction, which are very important in the assessment of VLDs. Finally, liver and spleen elastography complete the assessment by providing intrahepatic and intrasplenic stiffness measurements, offering further diagnostic information.
肝血管疾病（VLDs）包括不同的病理状况，这些状况会在门静脉系统、肝动脉或静脉流出系统层面影响肝脏血管。尽管可能需要血清学检查，有时还需要组织学检查来明确潜在诊断，但影像学在突出肝脏流入或流出道梗阻及其潜在病因方面起着关键作用。横断面成像提供了肝脏血管解剖结构和实质强化模式的全景视图，使其对VLDs的诊断和随访极为有用。然而，多参数超声分析提供的信息有助于区分急性和慢性门静脉血栓形成，区分门静脉的肿瘤侵犯与单纯血栓，并明确静脉流出道梗阻的原因。彩色多普勒分析可测量血流速度和方向，这在VLDs评估中非常重要。最后，肝脏和脾脏弹性成像通过提供肝内和脾内硬度测量值来完善评估，提供进一步的诊断信息。
