Hepatopulmoner sendrom tanısında kalın kesit reformatlı bilgisayarlı tomografi görüntülerinin değeri: Bir olgu sunumu

Year 2017, Volume: 30 Issue: 3, 185 - 187, 22.10.2017

Atilla Hikmet Çilengir , Şebnem Karasu Yusuf Kenan Çetinoğlu Muhsin Engin Uluç Özgür Tosun

https://doi.org/10.5472/marumj.370862

Abstract

Son dönem karaciğer hastalığında dolaşımdaki bazı mediatörlere

bağlı olarak hafif hipoksemiden hepatopulmoner sendroma

kadar uzanan spektrumda solunum komplikasyonları

görülebilmektedir. İntrapulmoner vasküler dilatasyonlar ve şantlar

bu komplikasyonlardan sorumludur. Radyografi ve bilgisayarlı

tomografi (BT) gibi toraks görüntüleme modaliteleri bu vasküler

patolojilerin değerlendirilmesinde kullanılabilir. Bu olgu

sunumunda bilinen karaciğer sirozu olan ve yeni başlayan egzersiz

dispnesi ile başvuran 37 yaşında kadın hastanın direkt grafi ve BT

bulgularından bahsettik. Hastanın toraks BT’sinde intrapulmoner

şantlar ve dilate vasküler yapılar mevcuttu. Hastamız, klinik,

laboratuvar ve radyolojik bulguları sonucunda hepatopulmoner

sendrom tanısını aldı. Kalın kesit reformatlı BT görüntüleri

intrapulmoner şantlar ve dilate vasküler yapıları kaynak görüntü

olarak kullanılan ince kesit BT’den daha iyi bir şekilde göstermiştir.

Bu nedenle siroz hastalarında, intrapulmoner şantlar ve vasküler

dilatasyonların belirlenmesinde toraks BT’lerinin reformatlı kalın

kesitlerle de değerlendirilmesini önermekteyiz.

Keywords

Bilgisayarlı tomografi, Hepatopulmoner sendrom, Karaciğer sirozu

Thick section reformatted computed tomography images are useful for the diagnosis of hepatopulmonary syndrome: A case report

Abstract

Respiratory complications, which range from mild hypoxemia

to hepatopulmonary syndrome, can occur due to some mediators

within the circulation in end-stage liver disease. Intrapulmonary

vascular dilatations and shunts are the reasons of these

complications. Thoracic imaging modalities such as radiography

and computed tomography (CT) can be performed to evaluate

these vascular pathologies. We reported a 37-year-old woman

with previously known liver cirrhosis, presented with new onset

exertional dyspnea. There were intrapulmonary shunts and dilated

vascular structures on her thorax CT. She was diagnosed with

hepatopulmonary syndrome by clinical symptoms, laboratory and

imaging findings. Thick section reformatted images of CT are

superior in demonstration of intrapulmonary shunts and dilated

vascular structures compared with thin section axial source

images; so we recommend that thorax CT of cirrhotic patients

must be evaluated with thick section reformatted images for the

determination of intrapulmonary shunts and dilated vascular

structures.

Keywords

Computed tomography, Hepatopulmonary syndrome, Liver cirrhosis

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