多层螺旋CT诊断肝门静脉积气的临床价值  

The clinical value of MSCT in the diagnosis of hepatic portal venous gas

作　　者：周健文 王强荣[1] 丁娟娟[1] Zhou Jianwen;Wang Qiangrong;Ding Juanjuan(Department of Radiology,Dongtai People′s Hospital,Jiangsu 224200,China)

机构地区：[1]江苏省东台市人民医院影像科,224200

出　　处：《实用医学影像杂志》2022年第6期607-610,共4页Journal of Practical Medical Imaging

基　　金：江苏省盐城市医学青年人才项目(盐卫科教[2018]16号)。

摘　　要：目的 分析肝门静脉积气的多层螺旋CT(MSCT)表现,探讨其临床价值。方法 回顾性分析9例经临床诊治证实的肝门静脉积气的影像资料,9例患者做了急诊MSCT平扫检查,其中2例患者还做了肠系膜CT血管造影术(CTA)增强扫描。结果 9例患者CT平扫在肝脏内的外周范围见条状气体低密度影,其中轻度积气3例、中度积气5例,1例肝外门静脉也见积气影,为重度积气;9例中2例小肠缺血性坏死引起重、中度的积气经抢救无效死亡,1例小肠缺血性坏死、2例为腹内感染引起中度积气经手术后痊愈,1例为肠梗阻引起中度积气及2例消化道肿瘤坏死、1例为胃手术后引起轻度积气保守治疗后痊愈。结论 MSCT能发现肝门静脉积气,提示患者病情改变,早期识别原发原因,对指导临床早期治疗、降低死亡率具有重要的价值。Objective To analyze the MSCT manifestations of hepatic portal venous gas(HPVG) and explore the clinical value of PVG imaging diagnosis. Methods The imaging data of 9 cases with HPVG confirmed by clinical diagnosis and treatment were analyzed retrospectively. Nine cases underwent emergency multisice computed tomography(MSCT) plain CT scan, and 2 cases underwent mesenteric CTA enhanced scan. Results Among 9 cases who underwent plain CT scan, they showed strip-shaped low-density shadow in the peripheral area in hepatic portal venous, including 3 cases with mild HPVG, 5 cases with moderate PVG, and 1 case with severe HPVG who showed gas outside liver;among 9 cases, 2 cases died of severe or moderate HPVG caused by ischemic necrosis of small intestine, 1 case with ischemic necrosis of small intestine, 2 cases with moderate HPVG caused by intra-abdominal infection, 1 case with moderate HPVG caused by intestinal obstruction and 2 cases with digestive tract tumor necrosis,and 1 case with mild HPVG caused by gastric operation were cured after conservative treatment. Conclusion MSCT can detect HPVG, prompt the condition changes of patients, and identify the primary cause early, which is of great value for guiding early clinical treatment and reducing mortality.

关 键 词：体层摄影术 X线计算机 门静脉 体层摄影术 螺旋计算机 

分 类 号：R575[医药卫生—消化系统] R816.5[医药卫生—内科学]