肝内门静脉螺旋CT成像诊断肝炎肝硬化  

Diagnosis of posthepatitic cirrhosis by intraheptic portal vein portography using spiral CT

作　　者：李毅红[1] 魏经国[1] 王耀程[1] 梁国民[1] 孙巧黎[1] 王新疆[1] 潘爱国[1] 

机构地区：[1]第四军医大学唐都医院放射诊断科,陕西西安710038

出　　处：《第四军医大学学报》2002年第5期440-443,共4页Journal of the Fourth Military Medical University

摘　　要：目的　探讨螺旋 CT肝内门静脉血管成像对肝炎肝硬化 (L C)的诊断价值 .方法　对 2 6例 L C患者和 30例正常人进行螺旋 CT门静脉系统血管成像 ,采用造影剂量 1.5m L· kg- 1 ,注射速率 3m L· s- 1 ,层厚 3mm,床速 5 mm·s- 1 ,重建层厚 2 mm,并进行最大密度投影血管重建 .在重建横断面图像上 ,于门静脉主干及其 1,2级分支、肝右前叶上段、肝左外下段门静脉分支分叉处总干近心端测量其血管短径 ,并计算各分级间比值 ,于脾门处测量脾静脉血管短径 .结果　 5 6例均清楚显示门静脉主干及其右前上段、左外下段门静脉分支 .2 6例 L C螺旋 CT肝内门静脉血管成像 (spiralCT portography,SCTP)显示门静脉分支级数减少 ,多为 3,4级 ,正常对照组多为 4～ 7级 ,平均等级分分别为 2 .9± 0 .5 ,3.3± 0 .5 (P<0 .0 1) .门静脉主干及右 1,2级分支增粗 ,其短径分别为 (14 .6± 2 .3) mm ,(13.3± 2 .2 ) mm和 (9.8± 1.0 )mm,右前上段 3级以下分支变细、扭曲、僵直 ,呈“枯树枝”状 ,3级分支管径为 (6 .1± 1.2 ) mm,正常组门静脉主干、右 1,2级分支及右前上 3级分支管径分别为 (12 .3± 1.0 ) mm ,(10 .6± 1.6 ) mm,(8.7± 1.4 ) mm和 (6 .8± 1.3) mm,两组对比差异显著 (P<0 .0 5 ) ;L C组门静脉左支角部、矢状部、?AIM To evaluate the spiral CT portography (SCTP) of intrahepatic portal vein in diagnosis of posthepatitic cirrhosis. METHODS SCTP was performed in 26 cirrhotic cases and 30 normal individuals. Maximum intensity projection (MIP) was conducted with the parameters as follows: 1.5 mL·kg -1 contrast, 3 mL·s -1 injection speed, 3 mm slice thickness, 2 mm reconstruction, and 5 mm·s -1 table speed. In reconstruction images, the minor calibers of portal vein were measured at proximal level of portal truck, grade 1, 2 tributaries, venous ramification at upper segment of right anterior lobe, as well as lower segment of left exterior lobe. The minor caliber ratios of graded tributaries were also calculated. Besides, the minor caliber of spleen vein was measured at spleen hilar level. RELULTS Portal vein and its two major tributaries were clearly observed. In 26 cirrho tic cases, visible tributaries were graded as 3, 4, while they were 4~7 in normal individuals. The average graded value in two groups were 2.9 ±0.5, and 3.3±0.5 respectively ( P <0.01). The main vein, the primary and secondary right anterior tributaries were all dilated, with the minor caliber of ( 14.6 ±2.3), (13.3±2.2), and (9.8±1.0) mm respectively, while the third right anterior tributaries and its branches became thin, distort, and stiff like withering branches, with the minor caliber of (6.1±1.2) mm. In normal group, the calibers of main portal vein, primary to third branches were ( 12.3 ±1.0), (10.6±1.6), (8.7±1.4), and (6.8±1.3) mm respectively. The difference between the two groups was significant ( P <0.05); The left portal vein turn site, sagittal part, secondary branches of left exterior lower segment were also dilated, with the minor caliber of (10.8 ±1.1), ( 9.5 ±1.5), and (5.2±1.4) mm respectively. While in normal group, they were (9.9±1.1), (8.4±1.5), and ( 4.3 ± 1.3 ) mm, and the difference was significant ( P <0.05); In right anterior upper tributariers with cirrhosis, the caliber r

关 键 词：肝硬化 螺旋CT 门静脉造影术 对比研究 诊断 

分 类 号：R816.5[医药卫生—放射医学] R575.204[医药卫生—临床医学]