CT门静脉造影三维重建诊断门静脉癌栓的价值  

Value of Three-Dimensional Reconstruction of CT Arterial Portography in the Diagnosis of Portal Vein Tumor Thrombi

作　　者：李宏 徐小虎 彭进 邰兆琴 LI Hong;XU Xiao-hu;PENG Jin;TAI Zhao-qin(Department of Imaging,Hai'an Hospital,Nantong University,Hai'an 226600,Jiangsu province,China)

机构地区：[1]南通大学附属海安医院影像科,江苏海安226600

出　　处：《中国CT和MRI杂志》2022年第12期101-102,共2页Chinese Journal of CT and MRI

摘　　要：目的探究CT门静脉造影三维重建诊断门静脉癌栓的价值。方法回顾性分析2018年1月~2021年6月于我院收治的70例门静脉癌栓患者临床资料,患者均行CT门静脉造影三维重建,总结门静脉癌栓分布情况及直接、间接征象。结果本研究中患者经CT门静脉造影三维重建诊断证实,70例患者中,共存在104个门静脉癌栓,其中单发门静脉癌栓者39例,多发门静脉癌栓者31例。在104个门静脉癌栓中,累及二级及二级以上门静脉分支者11个,占比为10.58%;累及一级门静脉分支者36个,占比为34.62%;累及一叶一级分支者18个,占比为17.31%;累及两叶一级分支者9个,占比为8.65%;累及门静脉主干者21个,占比为20.19%;累及肠系膜静脉或下腔静脉者9个,占比为8.65%。门静脉癌栓直接征象包括:门静脉增粗及充盈缺损、部分癌栓存在不均匀强化;间接征象包括:门静脉管壁强化、侧支循环形成、门静脉海绵样变、周围肝脏血流动力学改变。结论CT门静脉造影三维重建提供门静脉癌栓的全面资料,用于评价门静脉癌栓有一定价值。Objective To explore the value of three-dimensional reconstruction of CT arterial portography in the diagnosis of portal vein tumor thrombi.Methods The clinical data of 70 patients with portal vein tumor thrombi treated in the hospital between January 2018 and June 2021 were retrospectively analyzed.All patients underwent three-dimensional reconstruction of CT arterial portography,and the distribution status of portal vein tumor thrombi and direct and indirect signs were summarized.Results In this study,three-dimensional reconstruction diagnosis of CT arterial portography confirmed that there were 104 portal vein tumor thrombi among 70 patients,including 39 cases with single portal vein tumor thrombus and 31 cases with multiple portal vein tumor thrombus.Among the 104 portal vein tumor thrombi,11 thrombi(10.58%)were involved in the secondary and above portal vein branches,36 thrombi(34.62%)were involved in the primary portal vein branch,18 thrombi(17.31%)were involved in the single-lobe primary branch,9 thrombi(8.65%)were involved in the double-lobe primary branch,21 thrombi(20.19%)were involved in the main portal vein,and 9 thrombi(8.65%)were involved the mesenteric vein or the inferior vena cava.Direct signs of portal vein tumor thrombi included portal vein enlargement and filling defect and uneven enhancement of some tumor thrombi.Indirect signs were consisted of portal vein wall enhancement,collateral circulation,portal vein cavernous transformation and peripheral liver hemodynamic changes.Conclusion Three-dimensional reconstruction of CT arterial portography provides comprehensive data of portal vein tumor thrombi and has certain value on evaluating the portal vein tumor thrombi.

关 键 词：CT门静脉造影 三维重建 肝癌 门静脉癌栓 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学]