【原】198.Hepatic Vascular Shunt(2)（肝血管分流）

每天朗读一段医学影像学英语文章

Among hepatic tumours, AP shunts are most commonly identified in patients with hepatocellular carcinoma (HCC). They are also commonly seen in cirrhosis, especially after a portocaval shunt operation. These shunts are typically wedge-shaped, with or without internal linear branching structures in the arterial phase, and are iso- to slightly hyperattenuating during the portal venous phase. However, a follow-up radiological study may be required to exclude the possibility of a coexistent tumour. 

在肝脏肿瘤中，动门脉分流最常见于肝细胞癌的患者。也可见于肝硬化患者，特别是行门腔静脉分流术后。这些分流呈典型的楔形，动脉期内部伴或不伴线样的分支结构，门脉期等/稍高密度。但之后要进行随访检查，排除伴发肿瘤的可能性。

Tumour thrombi are seen most commonly in patients with HCC (Figure 4) and to a lesser extent in patients with cholangiocarcinoma or metastases, and also cause AP shunting. Trauma-related AP shunts may occur secondary to penetrating trauma, and can be caused by a liver biopsy or by percutaneous biliary catheterisation. Radiological imaging-guided intervention, such as embolisation, is performed if there is rapid development of life-threatening portal hypertension or high-output cardiac failure. If embolisation fails, surgery is often necessary.

肿瘤栓塞在肝细胞癌的患者中最常见，在小部分胆管细胞癌和转移的患者中也可出现，常导致动门脉分流。与创伤相关的动门脉分流可继发于穿刺伤，肝活检或者经皮胆汁引流。若出现危及生命的门脉高压或者高输出型心衰，则需进行影像引导下介入，比如栓塞。若栓塞失败，则需手术。

Notes:

1. hepatocellular carcinoma [hepətoʊ'seljʊlə] 肝细胞癌

2. cirrhosis [səˈroʊsɪs] n. 肝硬化

3. portocaval [pɔ:tə'keɪvəl] adj. 门（静脉与）腔静脉的

4. thrombi ['θrɒmˌbaɪ] n.血栓( thrombus的名词复数 )

5. cholangiocarcinoma [koʊlədʒi:oʊkɑ:sɪ'noʊmə] 肝胆管型肝癌

6. percutaneous [ˌpɜ:rkju:ˈteɪniəs] adj. 经皮的

7. biliary [ˈbɪlieri] adj. 胆汁的

8. catheter [ˈkæθɪtɚ] n. 导尿管，尿液管，导管

9. embolism [ˈɛmbəˌlɪzəm] n. 栓塞

10. thrombus ['θrɒmbəs] n. 血栓

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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