特发性非肝硬化门静脉高压症患者肝脏影像学和病理学特征分析*

doi:10.3969/j.issn.1672-5069.2023.01.024

摘要/Abstract

摘要： 目的分析特发性非肝硬化门静脉高压症(INCPH)患者肝脏影像学和病理学特征,并与肝硬化的鉴别要点。方法 2016年1月～2021年7月我院收治的INCPH患者16例和乙型肝炎肝硬化患者28例,常规进行超声、CT和MRI及肝穿刺活检检查。结果 INCPH与肝硬化患者在影像学检查发现的弥漫性结节样改变(0.0%对35.7%)、门静脉直径【9.7(7.2,11.6)mm对13.6(9.2,15.7)mm】、门静脉壁厚【2.6(1.4,4.0)mm对1.4(1.1,1.6)mm】方面比较,差异具有统计学意义(P<0.05);肝组织学检查发现,INCPH与肝硬化患者在门静脉区域纤维化、肝膈膜纤维化、肝小叶间静脉闭塞、肝细胞坏死和肝细胞水肿或脂肪变性方面【分别为100.0%对0.0%、18.7%对92.8%、56.2%对10.7%、0.0%对75.0%和12.5%对89.3%】,差异具有统计学意义(P<0.05)。结论 INCPH仍是一种病因不明的疾病,注意分析影像学和组织病理学特征可以作出与肝硬化的鉴别诊断。

关键词: 特发性非肝硬化门静脉高压症, 肝硬化, 影像学表现, 门静脉区域纤维化

Abstract: Objective The aim of this study was to summarize the imaging and liver histopathological features in patients with idiopathic non-cirrhotic portal hypertension (INCPH) and to find the differential clue from patients with liver cirrhosis (LC). Methods Sixteen patients with INCPH and twenty-eight patients with hepatitis B-induced LC were encountered in our hospital between January 2016 and July 2021, and all underwent ultrasonography, CT, MR and liver biopsies. Results The imaging check-up showed that there were significant differences as respect to liver diffuse nodular changes (0.0% vs. 35.7%), portal vain diameters [9.7(7.2, 11.6)mm vs. 13.6(9.2, 15.7)mm], and portal vain wall thickness [2.6(1.4, 4.0)mm vs. 1.4(1.1, 1.6)mm] between the two groups(P<0.05); the liver histopathological examination demonstrated that there were significant differences respect to portal vein region fibrosis, hepatic diaphragm fibrosis, hepatic interlobular vein occlusion, hepatocyte necrosis or edema and hepatocyte steatosis [100.0% vs. 0.0%, 18.7% vs. 92.8%, 56.2% vs. 10.7%, 0.0% vs. 75.0% and 12.5% vs. 89.3%] between the two groups (P<0.05). Conclusion INCPH is still a disease of unknown etiology. The liver imaging and histopathological features might help differentiate it from liver cirrhosis.

Key words: Idiopathic noncirrhotic portal hypertension, Liver cirrhosis, Imaging feature, Portal vein region fibrosis

许青, 杨健, 宗金娟. 特发性非肝硬化门静脉高压症患者肝脏影像学和病理学特征分析^*[J]. 实用肝脏病杂志, 2023, 26(1): 91-94.

Xu Qing, Yang Jian, Zong Jinjuan. Imaging and histopathological features in patients with idiopathic non-cirrhotic portal hypertension[J]. Journal of Practical Hepatology, 2023, 26(1): 91-94.

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特发性非肝硬化门静脉高压症患者肝脏影像学和病理学特征分析^*

Imaging and histopathological features in patients with idiopathic non-cirrhotic portal hypertension

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