门脉高压患者的多层螺旋CT血管造影检测

Multislice Spiral CT Angiography for Portal Hypertension

目的用多层螺旋CT进行门静脉CT血管造影(CTA)成像,了解门静脉高压症的病因,周围侧支血管及胃左肾静脉分流道的情况,为临床合理选择治疗方法提供影像学依据。方法对32例怀疑有门静脉高压的患者进行门脉CTA检查,分别行动脉期和门脉期双期CT扫描和重建。结果32例患者中有27例存在门脉高压,胃底、食道静脉曲张。其中4例为胰腺炎后上消化道出血患者,出血的原因是胰腺炎所致脾静脉中断,造成胃底静脉曲张出血;3例为肝内门脉海绵样变性;9例为门脉高压伴胃底-左肾静脉分流道;11例为单纯肝硬化、门脉高压。结论门脉CTA是门脉高压、食道和胃底静脉曲张患者的重要检查手段,可以明确发现食道、胃底静脉曲张的范围、程度及变异,并可发现非肝硬化性门脉高压的病因。

Objective CT angiography （CTA） of the portal vein system by 16 detector spiral CT was performed to determine etiopathogenisis, collateral and gastro-renal shunt in the patients with portal hypertension. Methods Thirty-two patients suspected of portal hypertension were examined and reconstructed by arterial-venous double-phase scan. Results Twenty-seven patients with portal hypertension were revealed by CT scan and reconstruction, with spleen vein thrombosis in 4 cases, congenital cavernous transformation of portal vein in 3 cases, gastro-renal shunt in 9 cases, and simply liver cirrhosis and portal hypertension in 11 cases. Conclusion Portal CTA is a significantly important and useful examination method for portal hypertension patients, it could help to determine not only the range, degree and variation of esophageal and gastric varices, but also the etiopathogenisis of non-cirrhotic portal hypertension.