多层螺旋CT双期血管造影对肝移植受体术前评估  

Dual-phase MSCT angiography used in preoperative evaluation for liver transplantation candidates

作　　者：郭冬梅[1] 边杰[1] 张喜友[1] 

机构地区：[1]大连医科大学第二临床学院放射科,辽宁116027

出　　处：《放射学实践》2004年第11期825-828,共4页Radiologic Practice

摘　　要：目的 :探讨多层螺旋CT血管造影 (MSCTA)对肝移植受体的术前评估。方法 :对临床上拟为肝移植受体的80例患者用容积再现 (VR)法进行双期CT血管重建 ,观察腹腔动脉干及其分支 (肝总动脉、胃左动脉、脾动脉 )、肠系膜上动脉、门静脉血栓及侧支循环血管 ,依据Michels标准进行肝动脉解剖分型 ,与Michels的 2 0 0例尸体解剖结果间的差异进行 χ2 检验。 16例行肝移植手术患者的MSCTA图像与手术结果进行对照分析。结果 :MSCTA清晰显示了 80例患者的肝动脉和门脉系血管结构 ,其中 62例 (77.5 % )肝动脉解剖为常见型 ,18例 (2 2 .5 % )肝动脉解剖为变异型 ,此结果和Michels的结果间差异有显著性意义 (P <0 .0 5 ) ,15例显示门静脉血栓 ,6例显示腹腔干狭窄 ,2例显示脾动脉瘤 ,2例显示肝动脉细小。 16例肝移植术受体的血管结构术前得到很好的显示。结论 :MSCTA作为无创性的检查方法 ,在血管方面能为肝移植受体提供综合的术前评估。Objective:To study whether MSCTA could be used for preoperative evaluation for orthotopic liver transplantation candidates.Methods:Eighty consecutive potential candidates for liver transplantation were evaluated with dual-phase CT angiography with 3D volume rendering.The two phases were used to create vascular maps of the celiac axis (including the origin of the hepatic common artery,left gastric artery and splenic artery)and origin of the superior mesenteric artery and to analyze portal vein thrombosis and vascular collateralization of portal vein.Statistical analyses were calculated by using χ 2 test for differences between the 80 cases of hepatic arterial anatomy and 200 cases of michels′ anatomic ateas.Appearance of MSCTA and operative results of 16 cases were analyzed.Results:MSCTA defined hepatic common artery and portal venous structures of 80 casas.Sixty-two patients (77.5%) had conventional and eighteen patients (22.5%)had nonconventional hepatic arterial anatomy.Significant differrence was found between the two groups in anatomy of hepatic artery(P<0.05).Portal vein thrombosis was shown in fifteen patients.Six patients had celiac axis stenosis,two patients had SA aneurysms,and two patients had small-caliber hepatic arterial vessels.Vascular structures of 16 operative cases were well defined.Conclusion:As a noninvasive examination,MSCTA can provide a comprehensive preoperative vascular evaluation for liver transplantation candidates.

关 键 词：肝移植 体层摄影术 X线计算机 血管造影 

分 类 号：R816.5[医药卫生—放射医学]