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目的研究肝小静脉闭塞病(hepatic veno-occ lusive disease,HVOD)的CT表现,探讨其影像学特征。资料与方法回顾性分析经临床或病理证实的3例HVOD患者的临床及影像资料,患者罹患HVOD前均有煎服“土三七”史。3例均行CT三期增强扫描,其中1例行CT三维血管重组;3例同时行B超检查;2例行肝组织穿刺活检。结果 3例CT平扫表现为腹腔积液、肝大、肝质不均匀性密度降低,增强扫描门静脉期及实质期呈现典型的斑片状或“地图”样强化及低灌注区。2例肝静脉显示不清,1例肝静脉可以显示,但有不同程度的狭窄。3例下腔静脉肝段变扁,但远端无扩张,亦无侧支循环形成,B超显示下腔静脉无梗阻。2例穿刺活检诊断为HVOD。结论 HVOD在CT增强扫描中具有典型表现,结合患者患病前服用“土三七”史可提示HVOD的诊断。
Objective To study the CT manifestations of hepatic veno-occlusive disease (HVOD) and to explore its imaging features. Materials and Methods Retrospective analysis of clinical and pathological evidence of the 3 cases of HVOD patients with clinical and imaging data, patients suffering from HVOD have Jianfu “soil” history. Three patients underwent CT three-phase enhanced scan, of which 1 case underwent CT three-dimensional vascular reconstruction; 3 cases underwent simultaneous ultrasound B; 2 cases of liver biopsy. Results The CT findings of 3 cases were ascites, the density of heterogeneity of liver and liver was decreased, and the typical portal site and portal vein period were typical patchy or “map” - like enhancement and hypoperfusion area. 2 cases of hepatic veins showed unclear, 1 case of hepatic veins can be displayed, but with varying degrees of stenosis. 3 cases of inferior vena cava hepatic segments become flat, but no expansion of the distal end, no collateral circulation formation, B-inferior vena cava showed obstruction. 2 cases biopsy diagnosed as HVOD. Conclusions HVOD is typical in CT enhanced scan. Combined with the patient ’s history before taking the disease, the diagnosis of HVOD may be prompted.