CT与MRI对土三七致肝窦阻塞综合征的诊断价值

The diagnostic value of CT and MRI on sinusoidal obstruction syndrome caused by Sedum aizoon

目的 探讨CT与磁共振成像诊断土三七致肝窦阻塞综合征的价值.方法 统计26例土三七致肝窦阻塞综合征患者的临床资料,分析CT和磁共振成像对土三七致肝窦阻塞综合征的诊断价值.结果 CT和磁共振成像平扫均显示有腹腔积液,肝肿大18例.CT平扫显示肝密度呈弥漫性降低19例,胸腔积液2例;增强扫描显示动脉期可见不同程度强化,肝动脉增粗扭曲11例;门静脉期可见斑片状、地图状异常强化,胆囊壁增厚23例;延迟期肝实质灌注不均匀,可见斑片状低密度灶.磁共振成像常规扫描显示肝实质信号不均,增强扫描显示动脉期肝实质轻度强化或不强化,肝动脉增粗扭曲15例;门静脉期可见肝实质不均匀斑块状、地图状信号影,胆囊壁增厚23例,门脉周围水肿2例;延迟期肝实质强化范围增大,呈"爪"形强化,低信号区域减小,肝静脉呈高信号或等信号,管腔较细但血流可流通.以病理活检结果为准,CT诊断土三七致肝窦阻塞综合征的准确率与磁共振成像比较差异无统计学意义(P>0.05).结论 土三七致肝窦阻塞综合征的CT和磁共振成像图像均有一定特征,两者可有效鉴别诊断肝窦阻塞综合征.

Objective To observe the value of CT and MRI in the diagnosis of hepatic sinusoidal obstruc-tion syndrome(HSOS)caused by Sedum aizoon.Methods 26 patients with HSOS caused by Sedum aizoon were selected as the subjects.The diagnostic value of the two methods for HSOS caused by Sedum aizoon was analyzed.Results CT and MRI plain scan showed all subjects had ascites and 18 patients had hepatomegaly.CT plain scan showed diffuse decrease in liver density in 19 patients and pleural effusion in 2 patients.Enhancement scan showed enhancement in arterial phase,and 11 patients had thickened and distorted hepatic arteries.There was patchy and map-like abnormal enhancement,and thickened gallblad-der wall in 23 cases in portal venous phase.In delayed phase,liver parenchymal perfusion was uneven,with patchy low-density lesions.MRI routine scan showed uneven liver parenchymal signals.Enhance-ment scan showed mild enhancement or no enhancement of liver parenchyma in arterial phase.Hepatic ar-tery was thickened and distorted in 15 patients.In the portal venous phase,there was uneven patchy and map-like signal shadow in liver parenchyma,23 cases with thickened gallbladder wall,and 2 cases with e-dema around the portal vein.In the delayed phase,the enhancement range of liver parenchyma increased,showing claw-shaped enhancement,and the low-signal area decreased.The hepatic vein showed high sig-nal or equal signal.The lumen was thin but the blood flow circulated.Based on the results of pathological biopsy,there was no significant difference in the accuracy between CT and MRI for diagnosis of HSOS caused by Sedum aizoon(P>0.05).Conclusions The CT and MRI images of HSOS caused by Sedum aizoon have certain characteristics,and the two can effectively differentiate and diagnose sinusoidal obstruction syndrome.