门静脉海绵样变的高场MRI诊断

High Field MRI Diagnosis of Cavernous Transformation of Portal Vein

目的探讨门静脉海绵样变(CTPV)的MRI表现及其诊断价值。方法收集16例经手术病理证实的CTPV患者,均做了MRI平扫、动态增强扫描,5例做了门静脉动态对比增强(DCE-MRA)检查。分析其MRI影像表现。结果16例CTPV,MRI上均明确了病因。CTPVMRI平扫表现门静脉主干、分支及属支闭塞,门静脉周围可见丰富的侧枝血管。动态增强动脉期7例见肝脏异常灌注,门静脉期肝门区周围异常丰富侧枝血管。DCE-MRA直观显示上述异常改变。6例伴胆管不规则狭窄。结论CTPV具有特征性的MRI表现,MRI对CTPV诊断及明确病因具有重要价值。

Objective To investigate MRI manifestions of cavernous transformation of portal vein（CTPV）,and to evaluate the MRI value in diagnosing CTPV. Methods 16 patients with CTPV proved by surgicopathology underwent MR plain scan,dynamic contrast enhancement and 5 patients were performed with dynamic contrast-enhanced magnetic resonance angiography（DCE-MRA）.The MRI features of CTPV were reviewed retrospectively. Results The etiology of 16 cases with CTPV was showed in MRI.The obstruction of portal vein and its branches and abundant collateral branch veins around it was exhibited in MR plain scan. Abnormal perfusion of liver parenchyma in 7 cases could be seen in arterial phase during MR dynamic enhancement. The abnormal collateral branch veins were enhanced during the portal phase.The above-mentioned alterations were displayed more obvious on DCE-MRA.The biliary duct was irregular stenosis in 6 cases. Conclusion CTPV has characteristic MRI manifestions. MRI can play an important role in diagnosing CTPV and definiting etiolog of CTPV.