螺旋CT门静脉成像评价门静脉病变的价值

Value of spiral CT portography in evaluating portal hypertension

目的 评价螺旋CT门静脉成像（CTP）显示门脉病变的价值。方法 51例患者分别进行了CTP和常规门静脉造影，两种检查的间隔时间为0—3d。其中42例为肝癌患者伴或不伴门脉高压，9例为单纯肝硬化伴门脉高压患者。分析CTP图像上门脉主干及左、右分支的开放性；侧枝循环发生的部位和分布范围，结果 与常规门脉造影（直接法和间接法）相对照，评价两者的符合情况。结果 在51例患者共153支门脉主干和左、右分支中，通畅107支，CTP显示104支；充盈缺损、闭塞46支，CTP显示4_4支，总符合率为96．7％（148／153）。除1例冠状静脉曲张及1例脐静脉开放未显示外，CTP清楚显影其余侧枝血管，总符合率为95．3％（41／43）。结论 与常规门静脉造影相比较，CTP能准确判断门脉开放性，显示门脉高压侧枝循环分布情况，基本能取代有创性的传统门脉造影术。

Objective To evaluate the value of spiral CT portography in demonstrating the PV systems and collaterals in portal hypertension. Methods Fifty-one patients with HCC and/or liver cirrhosis associated with portal hypertension underwent spiral CT portography and conventional portography. The potency of the main portal vein, its fight and left branches were examined. The distribution and extent of collaterals were also assessed. The findings of CTP were compared with those from conventional portography . Results In the 153 portal veins and branches of S1 patients, CTP displayed 104 of 107 patented portal veins and 44 of 46 obstructed ones with high concidence （96.7%, 148/153）. The presence of collaterals revealed by CTP was correlated well with portography,and the concidence rate is 95.3% （41/43）. Conclusion Compared with conventional portography, CTP can determine the portal venous patency accurately, and display collaterals with high concidence. It can essentially replace the invasive portography.