门腔间隙的CT和MRI研究——正常表现及临床意义

CT and MRI Evaluation of Portacaval Space:Normal Manifestations and Clinical Implications

目的：研究门腔间隙（PCS）的CT、MRI表现和解剖基础,获得门腔淋巴结（PCN）的正常值并探讨相关临床意义.方法：选取60例和40例分别行CT及MRI增强扫描患者的影像资料.所有患者均无腹部疾病的病史及相关症状和体征,影像学检查显示腹部无恶性肿瘤、炎症及外伤性病变.观察门腔间隙的CT、MRI表现,测量门腔淋巴结前后径.结果：本组100例中共有43例（43.0%）在CT或MRI上显示PCN,其最大前后径为（0.64±0.31）cm,95%可信区间为0.54～0.74 cm 64例（64.0%）PCS内显示肝尾状叶,其中10例（10.0%）显示乳头突,4例（4.0%）显示尾状突;26例（26.0%）显示门腔血管;5例（5.0%）显示胆囊管.PCS上段的主要解剖结构为肝尾状叶,而PCN、门腔血管多位于PCS下段.结论：PCS内以肝尾状叶和PCN最为常见,PCN的出现率为43.0%;PCN前后径的上限为1.0 cm,此值可作为判断PCN增大的基础和依据.

Objective：To evaluate the normal CT and MRI manifestations and the anatomic basis of the portacaval space （PCS）. To obtain the figure of the normal size of portacaval node （PCN） in Chinese and to address the related clinical implications. Methods：The CT and MR imaging data of 100 cases, with neither abdominal symptoms or signs, nor imaging manifestations of neoplasm, trauma or inflammatory diseases of abdomen, were included into the study randomly. 60 cases underwent contrast enhanced CT scan and 40 had MRI. The CT and MRI manifestations of normal PCS were studied and the maximal anteroposterior diameter of the PCN was measured. Results： The visualization rate of PCN, caudate lobe of liver,vessels and cystic duct within the PCS were 43.0% ,64.0% ,26.0% and 5.0% respectively. The maximal anteroposterior diameter of the PCN was （0.64±0.31）cm,and the 95% confidence interval was 0.54-0.74cm. The caudate lobe of liver was generally revealed in the upper part of the PCS and the PCN, the portacaval vessels and the cystic dust were revealed in the lower part of the PCS. Conclusion.. The visualization rate of PCN was 43.0% in Chinese. Taking lcm as the normal upper limit of maximal anteroposterior diameter in Chinese,it could provide a basic evidence for the diagnosis of the PCN enlargement.