多层螺旋CT门静脉成像对肝硬化门脉高压侧支循环的诊断价值  

The diagnostic value of multiple slice spiral CT portal venography in the collateral circulation of liver cirrhosis with portal hypertension

作　　者：高勇[1] 唐笑先[1] 师建强[1] 王坤[2] 牛金亮[3] 王峻[3] 

机构地区：[1]山西省人民医院,030012 [2]太原市传染病医院 [3]山西医科大学第二医院

出　　处：《实用医技杂志》2012年第10期1016-1018,共3页Journal of Practical Medical Techniques

基　　金：山西省人民医院青年基金项目(2010057)

摘　　要：目的探讨多层螺旋CT(MSCT)门静脉成像对肝硬化门脉高压侧支循环的诊断价值。方法对53例肝硬化门脉高压患者行门静脉CTA检查,并统计侧支循环的发生部位。受检者均行螺旋CT平扫及双期扫描,后处理方法采用最大密度投影(MIP)、多平面重建(MPR)、容积重建(VR)。结果 53例中,胃左静脉曲张33例(62%),胃后/短静脉曲张7例(13%),食管静脉曲张40例(76%),食管旁静脉曲张15例(28%),胃底静脉曲张29例(55%),胃/脾-肾静脉分流20例(38%),腹壁静脉曲张19例(36%),直肠静脉曲张3例(6%)。结论MSCT门静脉成像可精确显示各类侧支循环的部位、程度及走行,可为临床治疗前评估提供可靠的影像学依据。Objective To evaluate the diagnostic value of multiple slice spiral CT portal venography in the collateral circulation of liver cirrhosis with portal hypertension. Methods Fifty-three patients of liver cirrhosis with portal hypertension underwent the examination of CTA of portal vein, all parts of the collateral circulation were calculated. Noncontrast scan and the double-phase scan were performed, CT angiography using postprocessing techniques such as MIP, MPR, VR. Results In the CT portography of 53 patients, there were 33 cases with left gastric vein varices （62%）, 7 cases with posterior/short gastric vein varices（ 13% ）, 40 cases with esophageal varices（76%）, 15 cases with paraesophageal varices （28%）, 29 cases with gastric fundus varices （55%）, 20 cases with gastrorenal shunt or splenorenal shunt （38%）, 19 cases with anterior abdomen wall varices（36%）, 3 cases with rectal varices（6%）. Conclusion Multiple slice spiral CT can precisely display the location, extent and course of the collateral circulation. It can provide reliable imaging evidence for clinical evaluation before treatment.

关 键 词：肝硬化 高血压 门静脉 侧支循环 体层摄影术 螺旋计算机 

分 类 号：R575.2[医药卫生—消化系统]