64层螺旋CT门静脉造影在显示肝硬化门静脉高压侧支循环中的价值  

Evaluation of Computed Tomography Portography in Detecting Collateral Circulation of Liver Cirrhosis with Portal Hypertension:A 64-slice Spiral CT Study

作　　者：李大勇[1] 郭应林[1] 李大庆 陆海波[3] 黄亚华 姜慧杰 李金平 王金娥 

机构地区：[1]哈尔滨医科大学附属第二医院,黑龙江哈尔滨150086 [2]哈尔滨市道外区太平人民医院CT室,黑龙江哈尔滨150050 [3]哈尔滨医科大学附属肿瘸医院内二科,黑龙江哈尔滨150081

出　　处：《中国医学影像学杂志》2010年第4期343-347,共5页Chinese Journal of Medical Imaging

基　　金：黑龙江省自然科学基金资助项目(D2007-57);黑龙江省自然科学基金资助项目(42411671-X-09102);黑龙江省教育厅科学技术研究项目(11541166)

摘　　要：目的:评价64层螺旋CT门静脉造影对肝硬化门静脉高压侧支循环显示的价值。材料和方法:肝硬化患者28例,采用64层螺旋CT行动脉期、门脉期及平衡期扫描后,运用容积重建法(VR)、多层面重建法(MPR)和最大密度投影法(MIP)对门静脉及其分支进行重建,观察门静脉高压肝内门静脉、属支及侧支循环的影像学特征。结果:64层螺旋CT门静脉造影能准确显示侧支循环分布范围,初步评估病变程度;门静脉高压时,门静脉属支管径显著扩张(门静脉主干、脾静脉、肠系膜上静脉、胃冠状静脉)。胃冠状静脉曲张24例、食管胃底静脉曲张21例、食管周围静脉曲张17例、胃短静脉曲张10例、脾/胃-肾分流6例、脐静脉和腹壁静脉曲张5例、腹膜后静脉曲张2例和直肠上静脉曲张2例,门静脉海绵状变性1例。结论:64层螺旋CT门静脉造影能够多角度、准确地显示门静脉高压时侧支循环开放的情况,对判断病变程度、预测其并发症、选择治疗方案具有重要意义。Objective To evaluate the capability of computed tomography portography（CTP）in detecting collateral circulation of liver cirrhosis with portal hypertension using 64-slice spiral CT. Materials and Methods 28 hepatic cirrhosis patients under- went 64-slices spiral CT scan. Portal vein and their branches were reconstructed by maximum intensity projection （MIP）,volume rendering （VR） and multiple planar reformation （MPR） techniques after arterial phase, portal venous phase and balance phase scans. The images of portal venous, branches and collateral circulation were estimated. Results The collateral circulation in liver cirrhosis cases were displayed well by 64-slice spiral CT portography. The severity of collateral vessels was assessed initially. The diameters of portal bronches in hepatic cirrhosis patients were enlarged. （main portal vein.splenic vein, superior mesenteric vein and gastric coronary vein）. Gastric coronary veins varices were seen in 24 patients, esophageal varices in 21, around the esophageal varices in 17, short gatric vein varices in 10, shunt spleen/gastric-renal in 6, umbilical and abdominal wall vein varices in 5, retroperitoneal vein varices in 2, superior rectal veins varices in 2,portal sponge degeneration in 1. Conclusion The portography of 64-slice CT can display collateral circulation of portal hypertension distinctly and accurately. The portography of 64-slice CT can estimate the severity of the disease, predicate the complication and play a significant role in making a clinical treatment plan.

关 键 词：高血压 门静脉 体层摄影术 螺旋计算机 门静脉造影术 侧支循环 

分 类 号：R575.210.454[医药卫生—消化系统]