15例肝小静脉闭塞病患者的诊断

The diagnosis of fifteen patients with hepatic veno-occlusive disease

目的探讨肝小静脉闭塞病(hepatic veno-occlusive disease,HVOD)的诊断方法。方法回顾性分析本院2010年~2015年确诊HVOD的15例肝小静脉闭塞病的临床和病理资料。结果 15例患者CT平扫表现为肝脏增大,肝实质密度均匀减低,增强呈"地图状"强化,门脉期明显;肝静脉及下腔静脉肝段变细,肝静脉显示欠清晰。病理学表现为肝窦淤血、扩张,肝细胞出现不同程度变性、坏死。结论病理检查对确诊肝小静脉闭塞病影像诊断有重要价值,CT增强检查是诊断肝小静脉闭塞病的有效方法。

Objective To discuss clinical experiences in the diagnosis of fifteen patients with hepatic veno-occlusive disease （HVOD）. Methods The clinical data from 15 patients with hepatic veno-occlusive disease were analysed retrospectively. Results According to the results of the imaging examination and the clinical data, the CT scans showed increased liver volume and homogeneously or inhomogeneously decreased liver parenchyma density, and the enhancement scans showed map -shaped enhancement, especially in the portal phase. The hepatic veins and the hepatic segment of the inferior vena cava appeared thinner, and the hepatic vein could not be seen clearly. The characteristic histological changes included hepatic congestion, sinusoidal dilatation, and hepatocyte necrosis. Conclusion Liver biopsy is significantly valuable in the assessment of HVOD. Dynamic enhanced CT is an efficient method for the diagnosis of hepatic veno-occlusive disease.