三维血管能量成像对门静脉癌栓和血栓的鉴别诊断

The diffrental diagnosis of cancer emboland and thrombus in portal vein

目的探讨门静脉系统癌栓与血栓的三维血管能量成像(3D-PDA)的表现及其鉴别诊断。方法对47例经临床及病理证实的门静脉栓塞的患者(癌栓37例,血栓10例)进行三维血管能量成像检查,分析门脉癌栓与血栓的不同特点。结果三维血管能量成像显示癌栓内血流丰富,显示条状多分支或网状结构。三维血管能量成像显示门静脉血栓内无血流信号,靠近管壁的血流光滑平直,腔内见曲线状血流,局部充盈缺损。结论三维血管能量成像可以立体的显示血管走行及分布情况,有助于癌栓和血栓的鉴别诊断。

Objective To study the Three-dimensional power Doppler anglography images of the cancer embolus and thmmbus in porta vein to describe the respective features and summarize the differentiation completely. Methods Three-seven cases （37 cancer embolus and 10 thrombus） confirmed by autopsy and therapy were examined with Thn：e-dimensional power Doppler angiography to analysis the different traits of the two diseases.Results Three-dimensional power Doppler angiography manifests blood flow of cancer endolus, multifascicular strip structure or fonnatio reticularis. It manifests no blood flow in the thrombus of the porta vein, dose to vessel wall, blood flow goes smoothly, in the intracavitary curvilinear blood flow can be found, also filling defect in the local area. Conclusion Three-dlmensional power Doppler angiography can manifest blood vessel＇s courser and distribution from the three-dimensional, which can conduce to differential diagnosis from embolus to thrombus.