CT门静脉成像在门脉高压症个体化治疗中的价值

The value of 16-slice CT portal venography（CTPV） for personalized therapy of portal hypertension

目的评价16层螺旋CT门静脉成像（CT portal venography，CTPV）在门脉高压症个体化治疗中的价值。方法回顾分析我院2005年7月至2007年7月68例确诊门静脉高压症患者的临床资料。所有患者术前均进行CTPV检查，根据CTPV所见并结合患者肝功能情况，分别进行了脾切除术、门奇静脉断流术、分流术或断分流联合术。结果CTPV可以显示整个门静脉侧支血管系统。其中以胃左、食管旁、脾静脉曲张为主要表现45例，胃短、胃后静脉曲张7例，脐静脉曲张伴腹壁静脉曲张5例，门静脉海绵样变或栓塞8例，肠系膜上静脉血管闭塞3例。结论CTPV能显示门静脉主干和侧支血管开放的部位、范围及程度，有助于选择门脉高压症的手术方式，是一种重要的检查方法。

Objective To evaluate the value of 16-slice CT portal venography for personalized therapy of portal hypertension.Methods The clinical data of 68 patients with portal hypertension were retrospectively analyzed. CTPV was performed in every patient before operation.According to CTPV images and liver function, they received splenectomy,portal azygous disconnection,shunt operations,combined with splenorenal shunt and devascularization. Results CTPV depicted entire portosystemic collaterals.On CTPV images, left gastric varices, esophageal and paraesophageal varices ,splenic varices were main manifestations in 45 patients, short gatric veins or posterior gastric veins in 7, abdominal wall and paraumblical varices in 5, portal venous cavernous transformation or thrombosis in 8, superior mesenteric vein thrombosis in 3.Conclusions As a valuable portography method, CTPV provide the accurate information of the collateral circulation in patients with portal hypertension and help in the choice of portal hypertension surgical treatment.