Nakayama T, Hiyama Y, Ohnishi K, Tsuchiya S, Kohno K, Nakajima Y, Okuda K
AJR Am J Roentgenol. 1983 May;140(5):953-7. doi: 10.2214/ajr.140.5.953.
Thirty-two patients, 20 with hepatocellular carcinoma and 12 with liver cirrhosis, were examined by dynamic computed tomography (CT) using intravenous bolus injection of contrast medium and by celiac angiography. Dynamic CT disclosed arterioportal shunting in four cases of hepatocellular carcinoma and in one of cirrhosis. In three of the former, the arterioportal shunt was adjacent to a mass lesion on CT, suggesting tumor invasion into the portal branch. In one with hepatocellular carcinoma, the shunt was remote from the mass. In the case with cirrhosis, there was no mass. In these last two cases, the shunt might have been caused by prior percutaneous needle puncture. In another case of hepatocellular carcinoma, celiac angiography but not CT demonstrated an arterioportal shunt. Thus, dynamic CT was diagnostic in five of six cases of arteriographically demonstrated arterioportal shunts.
32例患者接受了动态计算机断层扫描（CT）及腹腔动脉造影检查，其中20例为肝细胞癌患者，12例为肝硬化患者。动态CT检查采用静脉团注造影剂的方式。动态CT显示，4例肝细胞癌患者及1例肝硬化患者存在动脉门静脉分流。在4例肝细胞癌患者中，有3例的动脉门静脉分流在CT上与肿块病变相邻，提示肿瘤侵犯门静脉分支。1例肝细胞癌患者的分流远离肿块。肝硬化患者的病例中未发现肿块。在最后这2例中，分流可能是由先前的经皮穿刺针引起的。在另一例肝细胞癌患者中，腹腔动脉造影显示存在动脉门静脉分流，而CT未显示。因此，在血管造影证实的6例动脉门静脉分流病例中，动态CT对其中5例具有诊断价值。
