门静脉海绵样变性向肝性侧支静脉的多层螺旋CT影像学研究  

The Study of Hepatopetal Collateralbranch Veins Caused by Cavernous Transformation of Portalvein through Multi-slice Spiral CT

作　　者：陈健湘[1] 杨欣欣 吕涵青[1] 胡元明[1] 段柯[1] 蒲学佳 CHEN Jian-xiang;YANG Xin-xin;LV Han-qing(Department of Radiology,Shenzhen Traditional Chinese Medical Hospital,Shenzhen 518033,Guangdong Province,China)

机构地区：[1]深圳市中医院放射影像科,广东深圳518033 [2]山西省中西医结合医院,山西太原030000

出　　处：《中国CT和MRI杂志》2018年第4期94-97,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨128层螺旋CT在门静脉海绵样变性(cavernous transformation of portalvein,CTPV)向肝性侧支静脉诊断中的价值。方法选取我院经CT诊断为CTPV的患者40例,所有病例均行上腹部螺旋CT平扫及三期增强扫描,图像均采用最大密度投影、多平面重组、容积再现(VR)等后处理进行血管成像,以显示异常的门静脉及向肝性侧支静脉情况。结果40例CTPV患者中,37例能清楚地显示CTPV向肝侧支静脉起源部位、走行及与周围脏器的关系,从而判断侧支静脉来源,占92.5%。主要表现为以下3支向肝性侧支静脉:(1)胆囊周围侧支开放者28例,占75.6%;(2)胆总管周围侧支开放者16例,占43.2%;(3)胰十二指肠周围侧支开放者11例,占29.7%。另外3例只能显示门静脉周围蜂窝状侧支血管网,无法识别侧支静脉的起源及走形途径,占7.5%。结论 MSCT检查能优化CTPV侧支静脉的显示,能准确地识别向肝性侧支血管的起止和走行路线,提供直观的诊断依据,是诊断CTPV的重要检查方法。Objective To explore the value of multi slices spiral computed tomography(MSCT)in the diagnosis of hepatopetal collateral branchveins cause by cavernous transformation of the portalvein(CTPV).Methods 40 cases of CTPV were diagnosed by CT in our hospital,plain scan and contrast-enhanced apiral CT were performed in all patients.Imaging data were postprocessed with Maximum intensity projection(MIP),multi-planar reconstruction(MPR),Volume rendering(VR)on blood Vessel to display the abnormal portal vein and hepatopetal collateralbranch veins.Results In the 40 cases of CTPV,37 patients could clearly show the relationship between CTPV to the origin,route and the surrounding organs of the hepatovenous vein,Which canestimate the source of the lateral branch vein.Their numbers accounted for 92.5%of the total.The following three hepatopetal collateral branchveins is the main performances:①28 cases of lateral branch opening of the gallbladder,accounted for75.6%,②There are 16 cases of the lateral branch opening of around common bile duct collateral,accounting for 43.2%,③11 cases of lateral opening of around the pancreaticoduodenum,accounted for29.7%.In addition.There are 3 cases can only show the honeycombed lateral branch of the portal vein,accounting for7.5%.Conclusion MSCT examination can optimize the display of the collateralbranch vein,Where can accurately identify the beginning and end of routes to hepatopetal collateralbranch veins.Which is an important method to diagnose the CTPV.

关 键 词：门脉海绵样变性 向肝侧支静脉 多层螺旋CT 门静脉高压 

分 类 号：R445.3[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]