MRI的LAVA技术对肝硬化门静脉高压症门静脉系统及侧支循环的评估  

The Evaluation of MRI LAVA Technique on Portal Venous System and Collateral Vessels of Portal Hypertension in Cirrhotic Liver

作　　者：刘汉菊[1] 金银华[1] 张霖[1] 宋杨[1] 

机构地区：[1]吉化集团公司总医院(北华大学第二附属医院)MRI科,吉林132000

出　　处：《临床放射学杂志》2013年第9期1291-1295,共5页Journal of Clinical Radiology

基　　金：吉林市科技发展计划资助项目(编号:201133106)

摘　　要：目的探讨MRI的肝脏快速容积成像(LAVA)技术在肝硬化门静脉高压症的门静脉系统解剖和门-体侧支循环方面的应用价值。方法对25例肝硬化门静脉高压症患者和45名正常健康对照行肝脏的MRI LAVA技术检查,测量门静脉各大血管分支的径线并进行比较;于MRI检查前后1周内行直接门静脉造影,以此对照,分析侧支循环发生的部位、引流路径及发生的范围。结果肝硬化门静脉高压症组门静脉主干(PV)、脾静脉(SV)、肠系膜上静脉(SMV)直径均大于对照组(t=3.81,2.81,2.38,P<0.05),肝内门静脉分支级数明显减少,但ChildPugh A级、Child-Pugh B、C级患者间PV直径及门静脉分支级数的减少无统计学意义(χ2=0.37,P>0.05)。共有16例显示胃左静脉(LGV)开放,Child-Pugh A级、Child-Pugh B、C级间PV直径与LGV直径比较无相关性(t=0.60,0.89,P>0.05)。同时MRI的LAVA技术共检出17例病例存在侧支循环血管,除2例孤立性胃底静脉曲张未检出外,其余侧支血管在LAVA技术成像上均能清楚显影,总符合率为92.0%(23/25)。结论 MRI的LAVA技术可以较好地显示门静脉系统血管及侧支循环,对于临床具有指导意义。Objective To evaluate the role of MRI LAVA Technique in detecting vascular anatomy of portal venous system and collateral vessels in portal hypertension. Methods 25 and 45 cases with or without portal hypertension were collected. The main branches of portal venous system were measured and analyzed with MRI LAVA technique, meanwhile DSA was examined in those with portal hypertension before or after MR LAVA technology about one week. The distribution and extent of the collateral veins by MRI LAVA Technique were compared with the result of portography. Results In portal hypertension group, the diameter of PV, SV, SMV were larger than that of control group respectively. The differences of PV and decreased of subbranching of portal vein between Child Pugh A, Child Pugh BC cases were not significant. Furthermore, 16 cases with left gastric vein were detected, comparison with the diameter of PV and LGV, there were not significant difference between Child Pugh A, Child PughBC cases. 17 cases with collateral vessels were detected, MRI LAVA technique dipicted the collateral vessels with a coincidence rate of 92.0% （23/25）. Conclusion MRI LAVA technique is very useful and reliable in visualizing portal venous system and collateral vessels of portal hypertension.

关 键 词：磁共振 LAVA技术 门静脉高压症 侧支循环 

分 类 号：R657.3[医药卫生—外科学]