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英文誌(2004-)

Journal of Medical Ultrasonics

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1984 - Vol.11

Vol.11 No.04

Original Article(原著)

(0219 - 0225)

肝内門脈血栓の超音波像—1剖検例での病理所見との対比—

Intrahepatic Portal Vein Thrombosis: Ultrasonographic and Pathologic Correlation

竹内 和男1, 3, 橋本 光代1, 中島 正男1, 3, 煎本 正博2, 3

Kazuo TAKEUCHI1, 3, Mitsuyo HASHIMOTO1, Masao NAKAJIMA1, 3, Masahiro IRIMOTO2, 3

1虎の門病院消化器科, 2虎の門病院放射線診断学科, 3沖中記念成人病研究所

1Department of Gastroenterology,Toranomon Hospital, 2Department of Diagnostic Radiology,Toranomon Hospital, 3Okinaka Memorial Institute for Medical Research

キーワード : ultrasound, thrombus, portal vein, intrahepatic portal branch

1) We reported on several ultrasonographic findings observed in a patient with widespread intrahepatic and extrahepatic portal vein thrombosis (PVT), which was later confirmed by autopsy.
2) Ultrasonography (US) revealed echogenic vascular structures (A), corresponding to the intrahepatic portal branches, were surrounded by a hypoechoic zone (B). Thin tubular structures and/or a narrow lumen (C) were also noted in the echogenic area and low-level echoes (D) were observed in the portal trunk (PT).
3) These ultrasonographic findings were more clearly demonstrated by ultrasonograms of the liver during the autopsy. Several large branches of the intrahepatic portal vein were partially obstructed (40 ˞ 60%) by relatively organized thrombi, and both the PT and umbilical portion were almost completely obstructed by relatively fresh thrombi (d).
4) A microscopic examination revealed organized thrombi (a) and recanalization (c) in the large portal branches. Widened periportal connective tissue with edema and abundant small lymphatic vessel-like structures (b) were also noted
5) A possible connection between ultrasonographic findings (A),(B),(C) and(D) and pathological findings (a), (b), (c) and (d) respectively, is strongly suggested by this study.