经颈静脉肝内门体分流术术前穿刺点的动态增强MRA定位  

Location of vascular puncture points with dynamic contrast-enhanced MRA before transjugular intrahepatic portosystemic shunt

作　　者：郭立[1] 杨达宽[1] 袁曙光[1] 闫东[1] 王家平[1] 杨青[1] 

机构地区：[1]昆明医学院第二附属医院放射科,云南昆明650101

出　　处：《中国医学影像技术》2010年第4期764-766,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨动态增强MRA(DCE-MRA)在经颈静脉肝内门体分流术(TIPS)术前定位中的作用。方法收集46例肝硬化门脉高压患者的MRA图像,测量并根据测量结果进行穿刺。结果肝静脉穿刺点到门静脉穿刺点平面上下垂直距离(AA’)为(22.63±10.21)mm;肝静脉穿刺点到门静脉穿刺点平面前后垂直距离(A’A’’)为(13.93±1.07)mm;前后穿刺角度为(31.64±9.23)°;肝静脉、门静脉穿刺点距椎体右缘距离分别为(23.51±2.12)mm、(38.51±5.36)mm;左右穿刺角度为向右偏(33.57±8.93)°。45例穿刺成功,且穿刺次数较少。结论门静脉穿刺点位置变化较大,定位需个体化。DCE-MRA是一种有价值且无损伤的定位方法,对TIPS术前定位有重要意义。Objective To explore the role in the localization of vascular puncture points with dynamic contrast-enhanced magnetic resonance angiography （DCE-MRA） before transjugular intrahepatic portosystemic shunt （TIPS）. Methods MRA images of 46 patients with portal hypertension were measured. The patients were then punctured according to the measurement Results The supero-inferior distant from the puncture point of hepatic vein to plane of right branch of portal vein （AA＇） was （22.63±10.21）mm,the anteroposterior distant from the puncture point of hepatic vein to plane of right branch of portal （A＇A＂） was （13.93±1.07）mm,the angle of sag was （31.64±9.23）°. The distant from puncture point of hepatic vein （AS） and right branch （BS） were （23.51±2.12）mm and （38.51±5.36）mm. The angle of cor was （33.57±8.93）°. Forty-five patients were successful punctured,and the time of puncture decreased. Conclusion The location of portal vein puncture point during TIPS are changeable,therefore individualized location of positioning is needed. DCE-MRA is a valuable non-invasive method of localization,playing an important role in localization of vascular puncture points of TIPS.

关 键 词：门体分流术 经颈静脉肝内 磁共振血管造影术 定位 

分 类 号：R575.21[医药卫生—消化系统] R445.2[医药卫生—内科学]