多层螺旋CT增强和门静脉重建成像对门静脉癌栓的诊断优势  

Diagnosis of portal vein tumor thrombus:the combination of enhanced multislice spiral computed tomography and portography

作　　者：史慧萍[1] 李兴江[1] 扈瑄[1] 王彧[1] 李金平[2] 姜慧杰[2] 

机构地区：[1]黑龙江省齐齐哈尔医学院第一附属医院CT室,黑龙江省齐齐哈尔市161042 [2]黑龙江省哈尔滨医科大学附属二院CT室,黑龙江省哈尔滨市150086

出　　处：《世界华人消化杂志》2012年第6期519-523,共5页World Chinese Journal of Digestology

基　　金：黑龙江省教育厅科学技术研究基金资助项目;No.11541166~~

摘　　要：目的:探讨16层螺旋CT增强扫描和门静脉重建技术多层面重建(multiple planar reformation,MPR)、最大密度投影(maximum intensityprojection,MIP)、容积重建(volume rendering,VR)的联合应用在门静脉癌栓中的诊断价值.方法:52例门静脉癌栓患者,采用16层螺旋CT行平扫、动脉期、门脉期及平衡期扫描.扫描参数:层厚2.5 mm,重建间距:0.625 mm,注射速率为3.5-4 mL/s,对比剂注入:80-100 mL,扫描时间为25-30 s,45-60 s和120 s.影像重建技术包括:VR、MPR和MIP,图像重建由1名诊断医生完成,另由2名诊断医生评价门静脉癌栓的范围、形态以及侧支循环情况.结果:动脉期癌栓呈不均匀强化35例(67.3%);47例门静脉增粗及充盈缺损(90.4%),门静脉管壁强化19例(36.5%),侧支循环形成13例(25%),门静脉受压13例(25%),门静脉海绵样变4例(7.7%),动-静脉瘘4例(7.7%).门静脉重建技术对门静脉癌栓的显示:MPR显示52例(100%),MIP显示43例(82.7%),VR显示39例(75%).结论:CT增强结合门静脉重建技术对门静脉癌栓显示更加全面,具有重要的临床应用价值.AIM：To evaluate the value of combined enhanced 16-slice spiral CT and portography reconstruction in the diagnosis of portal vein tumor thrombus.METHODS：Fifty-two patients with portal vein tumor thrombus underwent 16-slice spiral CT examination.A plain scan and triple-phase enhanced scans（arterial phase,portal venous phase,and equilibrium phase） were performed.Scanning parameters were as follows：a slice thickness of 2.5 mm,a reconstruction interval of 0.625 mm,a flow rate of 3.5-4 mL/s,80-100 mL of contrast agent,and scan time of 25-30 s,45-60 s,and 120 s,respectively.Image reformation,including volume rendering（VR）,multiplanar reformation（MPR） and maximum intensity projection（MIP）,was performed by one radiologist.Two radiologists assessed the scope,shape and collateral vessels of the thrombus.RESULTS：Thirty-five cases（67.3%） of portal vein tumor thrombus showed inhomogeneous enhancement in the arterial phase,and 47 cases（90.4%） had the enlarged portal vein and filling defect.Enhancement of the vessel wall was seen in 19 cases（36.5%）,collateral circulation formation in 13 cases（25%）,compression of the portal vein in 13 cases（25%）,and arterioportal fistula in 6 cases（11.5%）.Different portal vein reconstruction techniques showed different number of cases of portal vein tumor thrombus：52（100%） by MPR,43（82.7%） by MIP,39（75%） by VR.CONCLUSION：The combination of enhanced CT and portography reconstruction can reveal portal vein tumor thrombus completely and has important clinical value.

关 键 词：门静脉癌栓 体层摄影术 X线计算机 重建技术 三期增强 

分 类 号：R735.7[医药卫生—肿瘤]