门静脉血管瘤 CT 和 MRI 诊断  

CT and MRI findings of portal vein aneurysm

作　　者：申光武[1] 李明武[1,2] 徐振华[1] 

机构地区：[1]武警湖南总队医院放射科,湖南长沙410006 [2]第四军医大学西京医院消化介入科

出　　处：《实用放射学杂志》2015年第5期768-771,共4页Journal of Practical Radiology

摘　　要：目的：分析和评价门静脉血管瘤的 CT 和 MRI 影像学特征,提高对其诊断的准确性。方法回顾性分析9例经手术和病理证实的门静脉血管瘤 CT 和 MRI 表现。其中7例行 CT 扫描（平扫2例、平扫＋增强5例）,CTA 3例；MRI 平扫加增强3例。结果（1）门静脉血管瘤以中、老年人多见。（2）肿瘤发生于门静脉主干4例、门静脉与肠系膜上静脉汇合处2例、肝内门静脉-门静脉主干1例、肝内门静脉2例。（3）8例门静脉瘤表现为边界清楚的类圆形、卵圆形肿块；1例直径为4.3 cm 压迫门静脉主干导致门静脉高压、门静脉血栓形成。（4）CT 平扫表现为稍高于胰腺实质密度,与肝实质密度相仿。4例行增强扫描门静脉期可见明显强化,1例由于门静脉血栓形成门静脉期强化不明显。CTA 检查可显示肿块与门静脉血管的关系,并可显示门静脉血栓。3例 MRI扫描 T1 WI 低信号,T2 WI 均匀高信号,增强扫描门静脉期明显强化。结论 CT 及 MRI 诊断门静脉血管瘤各具有优势,两者相结合能提高此病诊断的准确性。Objective To evaluate CT and MRI findings of portal vein aneurysm（PVA）in order to improve its diagnostic accuracy.Methods CT and MRI findings of 9 patients with PVA proved by pathology and direct angiography were reviewed retrospectively.CT scanning was performed in 7 patients,including plain scan （n=2）,both plain and enhanced scan （n=5）,CT angiography （CTA）（n=3）.Plain and enhanced MRI scan were performed in 3 patients.Results （1 ）PVA showed a high predilection for old adults.（2 ）Of the 9 tumors,4 located in portal vein trunk,2 located in junction of superior mesenteric vein and portal vein trunk,1 located in intrahepat-ic-extrahepatic portal vein,2 located in intra-hepatic portal vein.（3）8 tumors were characterized as well-defined and quasi-circular mass.1 patient occurred portal hypertension,thrombus as the portal vein trunk was oppressed by the tumor.（4）Plain CT showed the mass was slightly higher than pancreas parenchyma density,and uniform with the density of the liver parenchyma.Enhancement scanning showed 4 tumors represented mild or moderate enhancement in portal venous phase except for 1 patient accompany with portal vein thrombus.CTA showed clearly the relationship mass with portal vein,and classified the type of PVA .The 3 lesions represented hypo-intensity on T1 WI and even hyper-intensity on T2 WI.Enhancement scanning showed the tumor was significantly enhancement in portal venous phase on T1 WI.Conclusion CT and MRI have their own advantages in the diagnosis of portal vein aneurysm.Com-bination of CT and MRI could improve the diagnostic accuracy of portal vein aneurysm.

关 键 词：门静脉血管瘤 计算机体层成像 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]