The cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CT during arterial portography.
The cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CT during arterial portography.
复制标题
动脉门静脉造影期间 CT 显示肝门门脉灌注非肿瘤性缺陷的原因。
DOI：
10.2214/ajr.172.2.9930791
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Y. Takeuchi
中科院分区：
文献类型：
--
作者：
T. Yamagami;Y. Arai;K. Matsueda;Y. Inaba;S. Sueyoshi;Y. Takeuchi
目的
我们研究了动脉门静脉造影（CTAP）中CT显示的肝门区非肿瘤性门静脉灌注缺陷的原因。
材料和方法
160例患者在肝总动脉造影过程中同时接受CTAP和CT检查，构成了我们研究的基础。在CTAP和肝动脉造影的CT表现上，确定了肝门区非肿瘤性门脉灌注缺损的频率、部位和形态。在CTAP上观察到非肿瘤性门脉灌注缺损的13例患者中，在选择性血管造影期间通过胃动脉、胰十二指肠动脉或两者进行CT检查。
结果
160例患者中33例在49个区域检测到非肿瘤性门脉灌注缺陷（IV段背侧，n = 30;外侧段背侧，n = 11; I段，n = 8）。在33名患者中，16名患者各有两处缺损。49例非肿瘤性门脉灌注缺损中，38例在肝动脉造影时CT表现为强化。在选择性动脉造影期间接受CT的13名患者中，在19个非肿瘤性门脉灌注减少的区域中，有16个区域出现了由于非门静脉流入而导致的增强（IV段背侧，11个区域中的9个;外侧段背侧，5个区域中的4个; I段，3个区域）。
结论
CTAP显示肝门区非肿瘤性门静脉灌注缺陷的主要原因是通过睫状体旁静脉系统的非门静脉供应导致门静脉流入减少。因此，在肝动脉造影过程中，此类病变在CT上也以高频率增强。
OBJECTIVE
We investigated the cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CT during arterial portography (CTAP).
MATERIALS AND METHODS
One hundred sixty patients who simultaneously underwent CTAP and CT during hepatic arteriography of the common hepatic artery formed the basis of our study. The frequency, site, and shape of nontumorous defects of portal perfusion in the hepatic hilum on CTAP and the findings on CT during hepatic arteriography were determined. In 13 patients in whom nontumorous portal perfusion defects were observed on CTAP, CT was performed during selective angiography via the gastric artery, pancreaticoduodenal artery, or both.
RESULTS
Nontumorous defects of portal perfusion were detected in 49 regions in 33 of the 160 patients (dorsum of segment IV, n = 30; dorsum of the lateral segment, n = 11; segment I, n = 8). Of the 33 patients, 16 had two defects each. Of the 49 nontumorous defects of portal perfusion, 38 showed enhancement on CT during hepatic arteriography. In the 13 patients who underwent CT during selective arteriography, enhancement due to nonportal venous inflow was seen in 16 of the 19 areas of decreased nontumorous portal perfusion (dorsum of segment IV, nine of 11; dorsum of the lateral segment, four of five; segment I, three of three).
CONCLUSION
The main cause of nontumorous defects of portal perfusion in the hepatic hilum revealed by CTAP is decreased portal inflow due to nonportal supply via the parabiliary venous system. Thus, such lesions were also enhanced at a high frequency on CT during hepatic arteriography.