摘要
目的:评价64排螺旋CT门静脉成像(CT portal venography,CTPV)显示门静脉高压侧支循环血管的应用价值。方法:收集50例门静脉高压患者CTPV资料,获得门静脉系统及侧支血管三维重建图像。结果:CTPV不仅直观地显示门静脉系全貌,还可显示整个门静脉侧支血管系统。50例患者中,胃左静脉曲张48例(96%)、食管胃底静脉曲张46例(92%)、食管周围静脉曲张41例(82%)、胃短静脉曲张19例(38%)、脾/胃-肾分流14例(28%)、脐静脉伴腹壁静脉曲张20例(40%)、腹膜后静脉曲张19例(38%)。门静脉及其主要属支闭塞导致门静脉海绵状变性8例(16%)。结论:CTPV可很好地显示门静脉高压侧支血管,有助于作出正确诊断,对选择治疗方案具有重要意义。
Objective：To evaluate the value of 64-slice CT portal venography（CTPV） in demonstrating portal system and its collaterals in portal hypertension. Methods：50 cases of portal hypertension were included in the study and undergone upper abdomen examination with 64-slice CT,image post-processing techniques such as MIP,MPR and VR were applied to display the portosystemic collaterals of portal venous system. Results：CTPV simultaneously depicted fourth or fifth branches of the intrabepatic portal veins and provided images of entire portosystemic collaterals,on CTPV images, left gastric varices were seen in 48 patients（96%）,esophygeal and /or fundic varices in 46（92%）,paraesophageal varices in 41（82%）,short gatric veins or posterior gastric veins in 19（38%）,shunt between spleen/gastric-renal vein in 14（28%）,abdominal wall and paraumblical varices in 20（40%）,retroperitioneal varices in 19（38%）,portal sponge degeneration in 8（16%）. Conclusion：CTPV can much more clearly demonstrate the collateral vessels in patients with cirrhosis and portal hypertension. An understanding of the varied appearances of acquired abnormalities of the portal venous system will allow more definitive diagnosis and help avoid false diagnosis of disease,and may play a significant role in marking a clinical treatment plan.
出处
《重庆医科大学学报》
CAS
CSCD
2008年第3期357-360,共4页
Journal of Chongqing Medical University
