肝癌门脉受侵的螺旋CTAP表现及临床意义  

Manifestations of Spiral CT Arterial Portography of Portal Vein Invasion in Patients with Hepatic Carcinoma

作　　者：金泳海[1] 刘一之[1] 丁乙[1] 倪才方[1] 朱晓黎[1] 孙鸽[1] 邢建明[1] 

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《实用放射学杂志》2002年第5期405-407,共3页Journal of Practical Radiology

摘　　要：目的　探讨肝癌患者门脉受侵的螺旋CT经动脉门脉造影 (S -CTAP)及其门静脉三维重建图像的表现。方法　 43例肝癌患者 ,其中原发性肝癌 2 7例 ,转移性肝癌 1 6例 ,均经肠系膜上动脉置管行S-CTAP。原始图像采用最大强度投影 (MIP)法行门静脉三维重建。结果　 2 6例肝癌患者的门静脉不同程度受侵 ,S -CTAP轴位像表现为门脉腔内局限性低密度区 ,门脉分支受压、移位、阻断等 ,肝实质呈三角形或楔形低密度区 ,边缘呈“直线”征。MIP三维血管成像能显示门脉树的整体观 ,清楚显示 4～ 5级小分支 ,其形态改变更具体 ,更直观。结论　S -CTAP结合门静脉三维重建能清晰显示门脉受侵的形态改变 。Objective To study the feature of portal vein invasion of spiral computed tomography during arterial portography(S-CTAP)and three dimensional reconstruction in patients with hepatic carcinoma.Methods 43 patients were examed by S-CTAP,27 patients were primary hepatic carcinoma,16 patients were liver metastatic carcinoma.S-CTAP were performed after a volume of 80 ml of megluming diatrizoate was injected with a power injector into SMA in all patients,and the primary images were postprocessed by maximum intensity projection(MIP).Results 26 patients were showed portal vein invasion.Low density regions in the portal vein trunks,oppression,replacement and obstruction of the portal vein branches,or'straight line'sign were seen in S-CTAP transversal images.MIP could show the entire portal vein tree,and the 4～5 grade branches were showed clearly,MIP is superior to transversal image on showing the small portal vein branches invasion.Conclusion S-CTAP combined MIP can clearly show the portal vein invasion and can be used as a new method assessing portal vein invasion.

关 键 词：肝癌 螺旋CT 经动脉门脉造影 门静脉三维重建 诊断 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]