肝脏血管周围晕环征的CT诊断及临床意义

CT diagnosis and clinical significance for liver perivascular lucency( PVL)

目的探讨肝脏血管周围晕环征(perivascular lucency,PVL)的CT诊断及其临床意义。方法回顾性分析18例肝脏PVL的CT及临床资料,总结其CT表现、分布特点、相关病理基础及疾病类型。结果肝脏CT增强扫描,PVL表现为肝脏门静脉左右支及其分支周围和/或第二肝门区的下腔静脉周围"双轨道征"或"日晕征"。18例PVL中,位于门静脉主干及左右分支者8例,门静脉中远段者4例,第二肝门区的下腔静脉周围者2例,同时出现上述2种或3种征象者4例。疾病类型中,慢性活动性肝炎7例,肝硬化4例,心功不全3例,外伤后2例,食管癌化疗后1例,长期大量饮酒者1例。结论肝脏PVL的CT增强表现和分布特点具有特异性,是反映肝内淋巴动力学和血液动力学异常的重要指标。

Objective To explore the clinical significance of CT in the diagnosis for liver perivascular lucency （PVL）. Methods The CT and clinical data of 18 patients with PVL were retrospectively analyzed, in which the CT manifestations, the characteristics of distributions, relevant pathological property, and the types of this disorder were summarized. Results On the enhanced CT scanning for liver, PVL exhibited the images, called ＇ dual-track＇ or＇ solar halo＇ , which were found in the left and right branch of portal vein, the areas of their small branches, and/or around the second portal vein and inferior cava] vein of liver. Of those 18 eases, 8 cases were located around Portal Vein and its left and right branches, 4 cases around middle and distal parts of Portal Vein, 2 cases around the areas of the second hepatic portal vein and inferior caval vein, 4 cases had 2 or 3 different PVL signs as described above. As for the types of these 18 cases of PVL, there were 7 cases of chronic hepatitis, 4 cases of hepatocirrhosis, 3 cases of cardiac insufficiency, 2 cases of trauma syndrome, 1 case of esophagus cancer underwent post-chemotherapy, and 1 case of long-term heavy alcohol drinking. Conclusion The manifestations and distribution of the enhanced CT for PVL have specificity, which are important parameters that can reflect the hepatic lymph liquid dynamic and abnormal hepatic blood dynamic.