螺旋CT血管成像对肝血管瘤并发周围型动-门静脉瘘的诊断价值  

Hepatic Hemangioma Accompanied with Peripheral Arterial-Portal Shunt:The Diagnostic Volue of Multi-slice Spiral CT Angiography

作　　者：温大勇[1] 伍兴友[1] 杨晔[1] 

机构地区：[1]银川市第一人民医院放射科,宁夏银川750001

出　　处：《实用放射学杂志》2008年第6期787-789,共3页Journal of Practical Radiology

摘　　要：目的探讨肝血管瘤并发周围型肝动脉-门静脉瘘(APS)多层螺旋CT血管成像的影像表现和诊断价值。方法搜集12例经多层螺旋CT三期扫描确诊的肝血管瘤并发周围型APS,对肝动脉期CT血管成像进行回顾性分析。结果容积再现(VR)和最大密度投影(M IP)三维重建法均可较好地显示周围型APS和肝实质一过性强化。APS血管成像可分为4种类型,类型Ⅰ:瘤周可见早显的门静脉分支,多有肝动脉支伴行,有时可见"双轨"征;类型Ⅱ:自瘤体发出数条纤细的早显小门静脉支,呈细线或虚线状,无肝动脉支伴行,早显的小门静脉支多位于短暂肝实质强化区中;类型Ⅲ:同时具备类型Ⅰ和类型Ⅱ的影像表现;类型Ⅳ:瘤周无早显的门静脉分支,仅显示楔形或片状浓染区。肝实质一过性强化表现为瘤周片状浓染区。结论多层螺旋CT血管成像是诊断肝血管瘤并发周围型APS有效的检查手段。Objective To analyze the multi - slice spiral CT（MSCT） angiographic features of hepatic hemangioma accompanied with peripheral arterial - portal shunt （APS） , and to assess the MSCT diagnostic ability and clinical value for peripheral APS. Methods 12 ca- ses of hepatic hemangioma accompanied by peripheral APS underwent triphase enhanced MSCT scan, the images were post - processed with maximum intensity projection （MIP） , volume rendering （VR） and then analysed. Results During hepatic arterial phase , the peripheral APS and transient hepatic parenchymal enhancement （THPE） could be visualized on MIP and VR. APS were classified into four types according to the findings on VR and MIP. Type Ⅰ ： Branch of the portal veins early enhancement in peritumoral wedge -shaped enhanced area, more frequently appeared as parellel track sign ; Type Ⅱ ： Showed early opacification of small portal branchs near tumors, APS more frequently found in peritumoral wedge - shaped enhanced area; Type Ⅲ ：Included both type Ⅰand type Ⅱ signs; Type Ⅳ ： Only showed peritumoral THPE. Conclusion MSCT angiography provides a new effective technique for demonstrating and understanding peripheral APS and THPE .

关 键 词：肝脏 肝血管瘤 动-门静脉瘘 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]