Subscribe to RSS
DOI: 10.1055/s-2001-11244
Farbkodierte Doppler-Sonographische Darstellung von intrahepatischen Venenkollateralen beim Budd-Chiari-Syndrom
Publication History
Publication Date:
31 December 2001 (online)
Zusammenfassung
Bei 3 Patienten mit ungeklärter portaler Hypertension wurden mittels farbkodierter Doppler-Sonographie (FKDS) intrahepatische veno-venöse Kollateralen diagnostiziert, woraufhin die Verdachtsdiagnose eines Budd-Chiari-Syndrom gestellt wurde. Die FKDS zeigte neben einer Reduktion des venösen Flusses eine venöse Flussumkehr in den aufsteigenden Schenkeln der venösen Kollateralen. Die Spektralkurvenanalyse der veno-venösen Shunts ergab in allen 3 Fällen ein flaches und aphasisches Muster. Die anschließend durchgeführte Kavographie bestätigte die sonographischen Befunde. Diese Beobachtungen untermauern den hohen Stellenwert der FKDS bei der primären Diagnostik von hepatischen veno-venösen Kollateralen beim Budd-Chiari-Syndrom.
Intrahepatic Venous Collaterals in Budd-Chiari-Syndrome Demonstrated by Colour-Coded Doppler Ultrasound
By means of colour Doppler ultrasound, veno-venous shunts were found in 3 cases, leading to the diagnosis of Budd-Chiari Syndrome. Pulsed and colour Doppler ultrasound showed a reduction in venous blood flow and the reversal of blood flow in the venous collaterals. Venous spectral Doppler wave forms in the veno-venous shunts were flattened and aphasic in all cases. Sonographic findings were confirmed by cavography. Our cases show that pulsed and colour Doppler ultrasound are a valuable tool in the initial diagnosis of veno-venous shunts associated with Budd-Chiari Syndrome.
Schlüsselwörter:
Veno-venöse Kollateralen - Budd-Chiari-Syndrom - Farbkodierte Dopplersonographie
Key words:
Veno-venous shunt - Budd-Chiari syndrome - Colour Doppler ultrasound
Literatur
- 1 Lasinski W, Zientarski B. The anastomotic system of sub-hepatic veins in man. Bull Assoc Anat. 1976; 60 559-566
- 2 Grant E G, Parrella R, Tessler F N. Budd-Chiari Syndrome: the results of duplex and color Doppler imaging. AJR. 1989; 152 377-381
- 3 Ralls P W, Johnson M B, Radin D R. Budd-Chiari Syndrome: detection with color Doppler sonography. AJR. 1992; 159 113-116
- 4 Grant E G, Schiller V L, Millener P. Color Doppler imaging of the hepatic vasculature. AJR. 1992; 159 943-950
- 5 Makuuchi M, Hasegawa H, Yamazaki S, Moriyama N, Takasayu K, Okazaki M. Primary Budd-Chiari Syndrome: Ultrasonic demonstration. Radiology. 1984; 152 75-79
- 6 Wang Z G, Zhu Y, Wang S H, Pu L P, Du Y H, Zhang H, Yuan C, Chen Z, Wie M L, Pu L Q. Recognition and management of Budd-Chiari syndrome: report of one hundred cases. J Vasc Surg. 1989; 10 149-156
- 7 Sherlock S. Diseases of the liver and biliary system. Ninth Edition. Blackwell Scientific publications.
- 8 Lee D H, Ko Y T, Yoon Y, Lim J H. Sonography and color Doppler imaging of Budd-Chiari syndrome of membranous obstruction of the inferior vena cava. J Ultrasound Med. 1993; 13 159-163
- 9 Millener P, Grant E G, Rose S, Duerinckx A, Schiller V L, Tessler F N, Perrella R R, Ragavendra N. Color Doppler imaging findings in patients with Budd-Chiari syndrome: correlation with venographic findings. AJR. 1993; 161 307-312
- 10 Körner T. Der diagnostische Stellenwert der portalen Duplexsonographie bei Leberzirrhose. Ultraschall Med. 1996; 17 79-84
- 11 Mori H, Hayashi K, Fukuda T, Matsunaga N, Futagawa S, Nagasaki M, Mutsukura M. Intrahepatic portosystemic venous shunt: occurrence in patients with and without liver cirrhosis. AJR. 1987; 149 711-714
- 12 Naganuma H, Ishida H, Niizawa M, Igarashi K, Shioya T, Masamune O. Hepatic involvement in Rendu-Osler-Weber disease: Findings on pulsed and color doppler sonography. AJR. 1995; 165 1421-1425
- 13 Bodner G, Glück A, Springer P, König P, Perkmann R. Aneurysmal portosystemic venous shunt: a case report. Ultraschall Med. 1999; 20 215-227
- 14 Akaki S, Kanazawa S, Gochi A, Nakamura K, Yasui K, Togami I, Hiraki Y, Hamazaki K. Asymptomatic membranous obstruction of the vena cava due to large intrahepatic collaterals. Cardiovasc Intervent Radiol. 1995; 18 403-405
- 15 Chevallier P, Peten E P, Marcy P Y, Fabiani P, Diaine B, Padovani B. Inferior vena cava hypoplasia with intrahepatic venous continuation: sonographic, angiographic and MR features including MR angiography. Clin Imaging. 1999; 23 99-102
- 16 Bongartz G, Wiesmann W, Wernecke K, Reiser M, Peters P E. Intrahepatic collateral veins in obliteration of the inferior vena cava. Radiologe. 1987; 27 568-571
- 17 Naganuma H, Ishida H, Konno K, Komatsuda T, Hamashima Y, Ishida J, Masamune O. Intrahepatic venous collaterals. Abdom Imaging. 1998; 23 166-171
- 18 Teichgraber U K, Gebel M, Benter T, Manns M P. Duplex ultrasound characterization of hepatic vein blood flow in healthy probands. Ultraschall Med. 1997; 18 267-271
Dr. Iris Eva Steingruber
Abteilung für RadiodiagnostikUniversitätsklinik Innsbruck
Anichstraße 35A-6020 Innsbruck
Phone: Phone:0512/504/2761
Fax: Fax:0512/504/2758
Email: E-mail:Iris.Steingruber@uibk.ac.at