197.Hepatic Vascular Shunt(1)（肝血管分流）

每天朗读一段医学影像学英语文章

The purpose of this pictorial review is to understand the embryological basis of the development of congenital hepatic vascular shunts and to review the multimodality imaging appearances of congenital and acquired hepatic vascular shunts. Hepatic vascular shunts are commonly seen in imaging. Familiarity with their characteristic appearances is important in order to accurately characterise these shunts and diagnose the underlying disorders.

该综述回顾了先天性肝血管分流的胚胎基础，还有先天性和获得性肝血管分流的多种影像表现。肝血管分流在影像检查中很常见。掌握其特征性表现对准确识别分流血管很重要，有助于诊断潜在疾病。

Intrahepatic vascular shunts are common; all intrahepatic vessels are associated with the formation of shunts. These include arterioportal (AP), portosystemic and arteriosystemic venous shunts. Rarely, systemic venous (i.e. hepatic vein to hepatic vein) shunts and portal-to-portal communications are seen [1]. The unique dual blood supply of the liver (approximately 75% portal venous and 25% arterial) means there is a compensatory relationship between the two sources. When vascular compromise occurs, it causes a macroscopic opening of the shunts between the hepatic arteries, the portal veins and the hepatic veins through physiological anastomoses, which become abnormally enlarged [1-3]. The purpose of this pictorial review is to illustrate the imaging appearances of hepatic vascular shunts on multidetector CT (MDCT) with sonographic and conventional angiographic correlation.

肝内血管分流很常见，所有的肝内血管都与分流的形成有关。包括动脉血管、门体系统、动脉系统静脉分流。比较罕见的是静脉系统分流（比如：肝静脉-肝静脉分流），还有门静脉-门静脉的分流。肝脏的供血比较独特，有两套供血系统（75%来自门静脉，25%来自肝动脉），两套系统间有补偿关系。当血管受压时，会导致肝动脉、门静脉、肝静脉之间出现生理性的吻合支开放，进行分流，从而导致其异常扩张。这张图片展示了肝血管分流在多层CT上的表现，同时还有声像图和常规的血管造影图。

FROM

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473823/

Notes:

1. embryological [ˌembrɪr'lɒdʒɪkl] 胚胎学的

2. congenital [kənˈdʒɛnɪtl] adj. 先天性

3. hepatic [hɪˈpætɪk] adj. 肝脏的

4. shunt [ʃʌnt] v. n.使转轨; 使分流

5. arterioportal [ˌmækrə'skɒpɪk] adj. 宏观的

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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