64层螺旋CT门静脉成像诊断门静脉海绵样变性

Value of 64-slice multi-detector computed tomography in the diagnosis of cavernous transformation of portal vein

目的探讨64层螺旋CT门静脉成像在门静脉海绵样变性(CTPV)诊断中的价值。方法收集并分析42例经证实的CTPV患者的64层螺旋CT门静脉成像资料。结果全部病例门静脉主干和(或)其分支闭塞和(或)狭窄。本组门静脉异常表现为门静脉主干和(或)其分支因栓子闭塞和(或)狭窄34例;门静脉受侵闭塞和(或)狭窄5例;门静脉原因不明的狭窄或闭锁3例。门静脉周围形成增粗、扭曲的侧支血管即门-门侧支血管:胆管周围静脉丛曲张39例;胆囊静脉丛曲张31例,有分支向肝内门静脉左支供血的胃左静脉曲张6例;并清楚显示多种门-体侧支血管;肝脏灌注异常18例;胆囊、胆管壁增厚28例。结论64层螺旋CT门静脉成像能很好地显示CTPV的特征,是很有效的诊断方法。

Objective To investigate the value of 64-slice multi-detector computed tomography （MDCT） in the diagnosis of cavernous transformation of portal vein （CTPV）. Methods Imaging data of 42 patients of CTPV with 64-slice MDCT were collected and analyzed. Results In all 42 cases, the trunk and branches of portal vein were narrow or obstructed. The appearances of abnormal portal vein included narrow or obstruction of trunk and branches of portal vein （34 cases）, narrow or obstruction of portal vein （5 cases）, as well as agnogenic narrow or obstruction of portal vein （3 cases）. There were portal collateral vessels around the main portal vein. Varices of peribiliary plexus, gallbladder and left gastric vein were found in 39, 31 and 6 cases, respectively. Abnormal hepatic perfusion was detected in 18 cases. Gallbladder and bile duct wall thickening were found in 28 cases. Conclusion MDCT is an effective method to diagnose CTPV.