64层螺旋CT门静脉造影及三维重建技术的临床应用  

The clinical application of portography and three-dimensional reconstruction of porto veins on 64-silce spiral CT

作　　者：郭成伟[1] 全显跃[1] 

机构地区：[1]南方医科大学附属珠江医院,广东广州510282

出　　处：《山东医药》2008年第8期15-17,共3页Shandong Medical Journal

基　　金：国家"863"计划项目(2006AA02Z346)

摘　　要：目的探讨64层螺旋CT门静脉造影(MSCTP)及三维重建技术的临床应用价值。方法对72例正常者(正常组)及30例门静脉病变者(病变组)以小剂量预注射法行MSCTP,采用三维(MIP、VR及MPR)重建技术观察门静脉分支、分级情况以及门静脉病变的影像学特征。结果正常组均获得良好原始图像和三维重建图像,重建图像均可观察到门静脉5级以上分支,共5种解剖类型。病变组依据病史和三维重建图像诊断为门静脉高压症伴静脉曲张21例,其中海绵样变性2例,曲张静脉主要分布于食管下段及胃底静脉、前腹壁静脉、直肠上静脉曲张、自发性脾/胃—肾静脉分流、左性腺静脉、腹膜后交通支、胆囊周围静脉曲张、脾—左卵巢静脉;门静脉栓子6例,肝动脉—门静脉瘘3例。结论MSCTP能清晰显示门静脉肝内分支、属支及侧支循环,对门静脉病变的病因诊断及外科手术方案的制定具有重要指导意义。Objective To evaluate the clinical value of portography and three-dimensional reconstruction of porto vein with 64 slices spiral CT. Methods 72 normal people and 30 patients with porto diseases who had performed MSCTP by Test Bolus. MIP, VR and MPR were employed for three-dimensional（3D） reconstruction, the grades of nomal porto ven- uos 3D images were estimated, and the feature of porto venuos diseases were analyzed. Results The normal groups had better original and 3D images. On 3D reconstruction images, the 5 -6 details of porto veinuos displayed well and had 5 types of porto veins. According to the patient history, the original images and 3D images information： 21 cases were finally diagnosed porto hypertension, 2 cases were porto sponge degenaration . Compensatory circulation in those cases were displayed well：the vein of hypomere of esophago and fundus gastricus, vena epigastrica, superior rectal veins, spontaneous gastro-renal or spleno-renal shunt, left gonadal vein and retroperitoneal communicans, cystic vein and eft ovarial vein diverges. 6 cases were porto vein emboli and 3 cases were hepatic artery-portal fistula. Conclusion The portography of 64-slice CT is a non-invasive modality, displaying porto venous system and compensatory circulation distinctly and stereoscopically. To a great extent, the portography of 64-slice CT is constructive to the porto ,diseases and the decision of approaches for surgical treatment.

关 键 词：多层螺旋CT 磁共振成像 三维重建 

分 类 号：R814.42[医药卫生—影像医学与核医学]