门静脉高压患者多层螺旋CT在体测量研究

The in vivo Measurement Investigation by Multi-slice Spiral CT in Patients with Portal Hypertension

目的通过多层螺旋CT门静脉血管成像,探讨门静脉高压患者门静脉系统管径、肝脾体积、肝实质强化与病因及肝功能之间的关系。资料与方法采用16排多层螺旋CT对126例临床和实验室指标提示门静脉高压患者和47例非门静脉高压者进行门静脉CTA,并进行胃左静脉、门静脉、脾静脉、肠系膜上静脉内径测量,肝脏、脾体积测量及门静脉期肝实质和门静脉主干CT值的测量,并用SPSS 11.0统计软件包对获得数据进行分析。结果门静脉高压患者与正常对照组相比,门静脉内径分别为(13.73±3.36)mm和(13.61±1.90)mm,脾静脉内径分别为(10.30±3.28)mm和(9.23±1.39)mm,肠系膜上静脉内径分别为(10.83±2.03)mm和(10.46±1.32)mm,胃左静脉宽度分别为(5.10±3.49)mm和(1.48±1.59)mm,肝脏体积分别为(1189.46±305.36)cm3和(1322.40±283.81)cm3,脾体积分别为(809.37±471.14)cm3和(255.53±110.35)cm3。两组间对比有统计学意义(P<0.05)。结论多层螺旋CT门静脉血管成像在显示门静脉高压患者相关血管形态、肝脾体积及肝实质强化等多方面能提供有价值的信息,可为临床治疗方案的选择和疗效的观察评估提供影像学依据。

Objective To discuss the application of multislice spiral CT in vivo measurement in the diagnosis of patients with portal hypertension. Materials and Methods 47 healthy cases and 126 cases with portal hypertension were performed MSCT portography. The inner diameter of portal system and the main collateral veins were measured in MIP image. The volume of liver and spleen were also measured in VR image. The CT values of liver parenchyma and main portal vein enhancement in portal vein phase were also measured. SPSS 11.0 statistic sofware was used. Results In the in vivo measurement by CT portal hypertension patients vs control, the inner diameter of portal vein was 13.73 ± 3.36mm vs 13.61 ± 1.90mm,spleen vein 10.30 ± 3.28mm vs 9.23 ± 1.39mm,superior mesenteric vein 10.83 ± 2.03mm vs 10.46 ± 1.32 mm, left gastric vein 5.10 ± 3.49mm vs 1.48 ± 1.59mm, The liver volume was 1189.46 ± 305.36cm^3 vs 1322.40 ± 283.81 cm^3 , spleen volume was 809.37 ± 471.14cm^3 vs 255.53 ± 110.35cm^3 , paraumbilical veins 7.50 ± 3.06mm, spleen renal shunt 12.90±6.97mm;gastric renal shunt 8.31± 3.66 mm, there was significant difference between two groups （ P 〈 0.05）. Conclusion The MSCT portography could give valuable information in vessel morphology, etiological diagnosis and liver function classify for treatment plan and therapeutic effect follow up.