MSCT血管成像及图像后处理技术在经门脉左支肝内门体静脉分流术中的应用  

Application of MSCT Angiography and Image Post-Processing Technique in Transjugular Intrahepatic Portosystemic Shunt

作　　者：高连荣 GAO Lian-rong(Department of Medical Imaging,the First People's Hospital of Zhumadian,Zhumadian 463000,Henan Province,China)

机构地区：[1]驻马店市第一人民医院医学影像科,河南驻马店463000

出　　处：《中国CT和MRI杂志》2022年第1期116-118,151,共4页Chinese Journal of CT and MRI

基　　金：河南省科技攻关计划项目(2018020618)。

摘　　要：目的MSCT血管成像与图像后处理技术在经门脉左支肝内门体静脉分流术(TIPS)中的临床应用价值。方法回顾性分析河南省驻马店市第一人民医院78例接受CT上腹部扫描患者的临床资料,分为肝硬化组、正常组,对其原始数据进行图像后处理,评估其分支分型、肝静脉间与和下腔静脉的夹角、门静脉MSCT显示结果、门静脉各段紧密接触面,评估肝脏体积与左、右肝体积。结果78例扫描者肝静脉分型:Ⅰ型52例,Ⅱ型26例;门静脉分型:Ⅰ型61例,Ⅱ型9例,Ⅲ型5例,Ⅳ型3例;肝硬化组的肝右静脉[(63.85±6.47)°]、肝左静脉与下腔静脉夹角[(68.75±6.93)°]均较正常组[(53.27±5.49)°、(56.72±5.76)°]大,肝中静脉与肝左静脉夹角[(64.31±6.58)°]大于正常组[(56.72±5.69)°,P<0.05];肝硬化组门静脉主干长度与直径、门静脉左支直径、门静脉分叉夹角均大于正常组(P<0.05);肝硬化组门静脉左支与肝脏紧密接触面积[(33.69±3.42)%]较正常组[(41.87±4.25)%]小(P<0.05);肝硬化组全肝体积、右肝体积小于正常组,而左肝体积大于正常组(P<0.05)。结论MSCT血管成像及图像后处理技术应用在TIPS术者,可准确评估其血管解剖信息。肝硬化状态下门静脉右支上壁和后壁,左支顶部、矢状部有密切联系,可作为门静脉安全穿刺点。Objective To analyze the clinical application value of multi-slice spiral CT(MsCT)angiography and image post-processing technique in transjugular intrahepatic portosystemic shunt(TIPs).Methods The clinical data of 78 patients who underwent upper abdominal CT scan in Zhumadian First People's Hospital,Henan Province were retrospectively analyzed.Patients enrolled were divided into cirrhosis group and normal group.Image post-processing of original data was performed.Branch classification,angle between hepatic veins,angle between hepatic vein and inferior vena cava,MsCT results of portal vein,close contact surface of portal vein segments,liver volume,and left and right liver volume were evaluated.Results Hepatic vein classification of the 78 patients found 52 cases of typeⅠ,and 26 cases of typeⅡ.Portal vein classification showed 61 cases of typeⅠ,9 cases of typeⅡ,5 cases of typeⅢand 3 cases of typeⅣ.The angle between right hepatic vein and inferior vena cava,angle between left hepatic vein and inferior vena cava,angle between middle hepatic vein and left hepatic vein in cirrhosis group[(63.85±6.47)°,(68.75±6.93)°and(64.31±6.58)°]were larger than those in normal group[(53.27±5.49)°,(56.72±5.76)°and(56.72±5.69)°](P<0.05).The length and diameter of portal venous trunk,left branch diameter of portal vein,and bifurcation angle of portal vein in cirrhosis group were larger than those in normal group(P<0.05).The close contact area between left branch of portal vein and liver in cirrhosis group[(33.69±3.42)%]was smaller than that in normal group[(41.87±4.25)%](P<0.05).The whole liver volume and right liver volume of cirrhosis group were smaller than those of normal group,while left liver volume was larger than that of normal group(P<0.05).Conclusion The application of MsCT angiography and image post-processing technique to patients undergoing TIPs can help accurate evaluation of vascular anatomical information.There is close connection among upper wall and posterior wall of portal venous right branc

关 键 词：MSCT 血管成像 图像后处理 经门脉左支肝内门体静脉分流术 

分 类 号：R445.3[医药卫生—影像医学与核医学] R657.3[医药卫生—诊断学]