肝内门-体静脉分流的多层螺旋CT诊断(附7例报告)  

MSCT Diagnosis of Intrahepatic Portosystemic Venous Shunts

作　　者：张翔[1] 于长鹿[1] 韩玉娟[1] 白人驹[2] 

机构地区：[1]天津市第三中心医院放射科,300170 [2]天津医科大学总医院

出　　处：《临床放射学杂志》2009年第4期510-513,共4页Journal of Clinical Radiology

摘　　要：目的探讨肝内门-体静脉分流(intrahepatic portosystemic venous shunts,IPSVS)多层螺旋CT(MSCT)的表现及其诊断价值。资料与方法从3360例接受MSCT动态增强检查并行多平面重组(MPR)、曲面重组(CPR)及容积再现(VR)等后处理的患者资料中,选出7例IPSVS病例,回顾性分析其MSCT表现。结果7例中6例伴有肝硬化、门静脉高压,在MSCT像上均出现门静脉右后支增粗,并沿肝裸区迂曲走行,最终汇入下腔静脉,在CPR及VR图像上显示更加逼真。1例无肝脏基础病的IPSVS,其MSCT图像显示门静脉右后支与肝右静脉间形成动脉瘤样通路,其彩色多普勒血流显像(CDFI)和VR图像清晰地显示了分流血管的情况。结论采用MSCT的二维MPR、CPR和三维VR等后处理技术,能清晰、逼真地显示IPSVS血管全程走行及分流道局部情况,可作为IPSVS的主要诊断手段。Objective To discuss the diagnostic value of MSCT in the diagnosis of intrahepatic portosystemie venous shunts （IPSVS）. Materials and Methods 7 cases of IPSVS were selected from 3360 patients who were performed by dynamic contrast enhanced MSCT and subsequent post-processing images of MPR, CPR, and VR. The CT findings of them were analyzed retrospectively. Results 6 cases of IPSVS with concomitant cirrhosis,hypertension of portal vein showed dilated right posterior branch of portal vein,and the vessel extended into inferior vena eava along the bared region of liver. The abnormal shunts could be demonstrated vividly with CPR and VR images. 1 case of IPSVS with no basic liver diseases had an aneurismal vessel linked the right posterior branch of portal vein with the right hepatic vein on both contrast enhanced MSCT axial and VR images and CDFI. Conclusion The whole path and local shunt vessels of IPSVS can be described clearly and vividly by post-processing MSCT images of MPR, CPR, and VR. MSCT can be used as the primary diagnostic modality to IPSVS.

关 键 词：肝脏 静脉分流体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]