多层螺旋CT门静脉造影诊断肝硬化门静脉高压

Multi-slice spiral CT portal venography in diagnosing liver cirrhosis with portal hypertension

目的 评价门静脉CT血管造影对肝硬化门脉高压患者的诊断价值。方法 对 43例经临床、肝功能和影像学检查诊断的肝硬化门脉高压患者进行门静脉CT血管成像 (CTPV) ,对门静脉主干、主要属支和侧支循环血管进行显示和测量。结果 43例患者均成功地实施了门静脉CTPV ,门静脉主干显示率 10 0 % ,胃左静脉 97.6% ,胃短静脉 44 .2 % ,食管胃底静脉曲张 90 .7% ,脾 /胃肾分流 2 8.7% ,脐静脉、腹壁静脉曲张分别为 46.5 %、44 .4%。其中门静脉主干宽度为 (13 .94±2 .47)mm ,胃左静脉主干宽度为 (5 .62± 2 .40 )mm。结论 CTPV可显示肝硬化门脉高压患者的门 体静脉之间侧支循环血管 ,有助于对门脉高压合并消化道出血患者选择合理治疗方案及进行疗效随访。

Objective To evaluate the usefulness of multi slices spiral CT portal venography (CTPV) in diagnosis and management of liver cirrhosis with portal hypertension. Methods Total 43 cases, 27 male, 16 female, with average age of (51.44±11.36) years old, proven clinically of cirrhosis with portal hypertension, underwent multi slices CT (MSCT) and CT portal venography (CTPV). Results On CTPV, the main stem of portal vein (100%), left gastric vein (97.6%), short gastric vein (44.2%), esophygeal and/or fundic varices (90.7%), shunt between spleen/gastric renal vein (28.7%), paraumbilical (46.5%) vein and abdominal wall veins (44.4%) were clearly depicted. The diameter of portal vein was ( 13.94 ±2.47) mm,and (5.62±2.40) mm of left gastric vein. Conclusion High quality CTPV can be obtained with MSCT. Multi planner MIP is the basic 3D reformatting technique for CTPV. The clearly depicting of portosystemic correlation is helpful to the treatment and following up for cirrhotic patient with up gastric intestinal bleeding.