胎儿肝静脉-门静脉分流的产前超声诊断

Prenatal ultrasonographic diagnosis of fetal portal-hepatic venous shunt

目的 探讨胎儿肝静脉-门静脉分流的产前超声表现及诊断价值.方法 回顾性分析10例肝内门静脉-肝静脉分流胎儿的超声声像图特征.结果 10例肝静脉-门静脉分流中门静脉左支-肝左静脉分流3例,门静脉-肝中静脉分流2例,门静脉-肝右静脉分流2例,两处及以上静脉分流3例,10例肝内门静脉-肝静脉分流均有共同的声像图特征.①二维超声上肝静脉远端显像,门静脉与肝静脉远端在同一平面显示,两者借无回声区相通.②彩色多普勒显示无回声区内充满彩色血流信号.③频谱多普勒检测无回声区内的血流频谱类似门静脉频谱.结论 产前超声在胎儿肝静脉-门静脉分流的无创检查中有重要的临床应用价值.

Objective To evaluate prenatal sonograpic findings and clinical value in fetus with congenital portal-hepatic venous shunt.Methods The prenatal ultrasonographic characteristic of ten cases of congenital portal-hepatic venous shunt were analyzed and summarized.Results Three cases had portal vein-left hepatic venous shunt,two cases with portal vein-right hepatic venous shunt,two cases with situs inversus of left right portal vein,and three cases with multiple shunt among portal and hepatic veins.All the 10 cases with portal-hepatic venous shunt had common sonographic features,①Two-dimensional ultrasound revealed the distal hepatic veins.The hepatic vein and portal vein were both visualized on the same plane and connected by an anechoic area.②Vascular signal were noted inside the anechoic area.③Blood flow inside the anechoic area demonstrated by spectral Doppler was similar to that of the portal vein.Conclusions Prental ultrasonography is valuable in the diagnosis of fetal portal-hepatic venous shunt.