64层CT在儿童门静脉海绵样变性手术治疗中的价值

64-slice spiral CT cavernous transformation of portal vein

目的探讨64层CT在门静脉海绵样变性术前病情判断及手术方式选择中的作用。方法总结本院12例门静脉海绵样变性患儿病变的部位及范围，侧支循环情况，与患儿手术治疗方式对比分析。结果12例患儿中5例食管胃底静脉曲张，行胃底及食管下段血管断流术和脾切除术，4例仅行脾切除术，3例病变累及肝内门静脉行活体肝移植。自发性脾／胃-肾静脉分流8例，腹膜后Retzius静脉丛（RV）开放4例，术中保留。术后I例肝移植出现门静脉血栓死亡，其余无明显并发症。结论64层螺旋CT血管成像可清楚显示门静脉及分支，侧支循环建立情况，有助于术前手术方案选择。

ObJective To investigate the role of 64-slice CT in imaging of the cavernous trans- formation of portal vein. Methods The site and the extent of collateral circulation in 12 cases of hospi- tal cavernous transformation of portal vein （CTPV） were analyzed. Results Five cases of 12 children suffered from esophageal varices and treated with the lower esophageal and gastric devascularization and splenectomy. Another 4 patients only underwent splenectomy. Three patients with intrahepatic portal vein underwent living-related liver transplantation. There were 8 cases of spontaneous spleen/ stomach-renal shunt, 4 cases of Retzius vein dilatation, which were left intact during surgery. One pa- tient died from portal vein thrombosis after liver transplantation, and the rest of patients had no signif- icant complications. Conclusions Cavernous transformation of portal vein can be clearly visualized by 64-slice spiral CT angiography. This may help pre-operative surgical planning.