区域性门静脉高压症的多层螺旋CT诊断  

Multi-slice spiral CT diagnosis of regional portal hypertension

作　　者：孙鹏飞[1] 颉克蓉[1] 曹向荣[1] 朱浩[1] 徐瑞[1] 张垚[1] 

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030

出　　处：《实用放射学杂志》2013年第7期1108-1111,共4页Journal of Practical Radiology

摘　　要：目的探讨区域性门静脉高压症的多层螺旋CT诊断策略。方法50例区域性门脉高压症患者，进行64层螺旋CT4期增强（动脉期、门静脉血管成像期、门静脉期、延迟期）扫描，观察门静脉高压症的病因、门静脉CT血管成像的效果及侧支静脉曲张的特征。结果50例患者中胰腺癌23例（46％），胰腺炎17例（34％）．其他10例（20％），包括胃癌（4例）、实性假乳头状瘤（1例）、胰岛细胞瘤（1例）、胃恶性间质瘤（1例）、肾癌（1例）、腹腔纤维肉瘤（1例）、脾动脉瘤（1例）。门静脉血管成像期门静脉及其属支、侧支循环通路成像良好，其中孤立性胃底静脉曲张率74％、胃网膜静脉曲张率92％、胃短静脉曲张率68％、脾一肾／胃一肾分流率20％、胃冠状静脉曲张率16％；结合动脉期、门静脉期及延迟期．胰腺病变的CT特征能够较好地显示。结论MSCT4期增强扫描方案有助于区域性门脉高压症的诊断，其可以指导临床制订有效的治疗方案。Objective To investigate diagnostic strategy of regional portal hypertension （RPH） with multi-slice spiral CT （MSCT）. Methods Contrast-enhanced CT, including arterial phase, portal vein CT angiography（CTA} phase, portal vein phase and delay phase was performed in 50 patients with RPH. Then, the etiological factor resulted in RPH,imaging quality of portal vein CTA and CT feature of collateral circulation were observed. Results In fifty patients with RPH , pancreatic cancer was found in 23 （46%） patients, panereatitis was found in 17 （34%） patients, and other 10（20%）patients, including gastric carcinoma（4 cases）, pancreatic solid pseudopapillary tumor（ 1 case）, islet cell adenoma（ 1 case）, gastric malignant interstitialoma（ 1 case）, renal carcino- ma（ t case）, abdominal cavity fibrosarcoma[ 1 case） and splenic artery aneurysm（1 case）. Portal vein and varicose vein in all patients were clearly displayed on portal vein CTA phase, collateral circulation in this study included gastric fundus varix（ 74% ）, gastroepip- loic varix（ 92% ）, short gastric varix （ 68% ） , spleno-renal/gastro-renal shunt （ 20% ） and coronary gastric varix （ 16% ） ; combined with arterial phase, portal venous phase and delay phase, CT features of pancreatic diseases were displayed well. Conclusion Four- phase contrast-enhanced MSCT is helpful to the diagnosis of RPH, which can guide clinician to formulate the effective treatment pro- gram.

关 键 词：计算机体层成像 门静脉高压症 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.6[医药卫生—放射医学]