门静脉海绵样变性的MRI诊断

MRI features of cavernous transformation of portal vein

目的分析门静脉海绵样变性的MRI特征。方法分析20例经手术病理或DSA证实的门静脉海绵样变性患者的MRI平扫、动态增强扫描及动态增强磁共振血管成像(DCE-MRA)的影像表现。结果20例患者中,11例为原发性肝细胞癌,3例为脾切除术后,5例为肝硬化,1例原因不明。门静脉海绵样变性在MRI平扫图象上,表现为门静脉主干或分支闭塞,周围可见由侧支静脉形成的团块状、网状异常软组织信号影,增强扫描门静脉期上述软组织影明显强化,表现为扩张迂曲的网状血管结构。增强扫描1例出现动脉期肝实质一过性灌注异常,2例见门静脉提前显影。1例可以出现肝外胆管低位梗阻。结论MRI能很好地显示门静脉海绵样变性的特征,是有效的诊断方法。

Objective To evaluate the MRI findings in cavernous transformation of portal vein （CTPV） patients. Methods MRI findings of the plain MRI , dynamic enhanced MRI or DCE-MRA in 20 patients with CTPV confirmed by surgery or DSA were analyzed retrospectively. Results Among these 20 patients, 11 case had primary hepatocellular carcinoma, 3 cases had splenectomy, 5 cases had hepatic cirrhosis and 1 case was unknown aetiology. On plain MRI, obliteration of portal vein was found, and mass-like or reticular abnormal soft tissue signals were found around the vein in all cases, which were produced by collateral vessels. On dynamic enhanced MRI scans, abnormal enhanced collateral veins during portal phase were demonstrated in all cases and abnormal hepatic perfusion during arterial phase in 1 case and 2 cases had early enhancement in portal vein. 1 case had obstruction in lower extrahepatic bile duct. Conclusion The characteristic findings of CTPV can be revealed on MRI. MRI is an effective method for diagnosing CTPV.