门静脉海绵样变的CT诊断

Diagnosis of cavernous transformation of portal vein by computed tomograhpy (CT)

目的分析门静脉海绵样变（ＣＴＰＶ）病人的ＣＴ表现和特征，探讨ＣＴ诊断该病的价值。材料与方法１０例门静脉海绵样变病人均做腹部ＣＴ平扫和增强扫描，分析其ＣＴ表现，其中６例经数字减影血管造影（ＤＳＡ）证实，４例经手术证实。结果主要ＣＴ表现为门静脉走行区结构紊乱，正常结构消失；在门静脉走行区出现血管样结构或迂曲、扩张窦隙样血管结构，在门静脉期明显强化；在动脉期可见周围肝实质短暂灌注异常，表现为带状高密度影，而在静脉期迅速消失。结论ＣＴ是诊断门静脉海绵样变性的有效方法，可为临床采取正确的治疗措施提供必要的依据。对ＣＴ表现不典型病例，结合ＤＳＡ或超声检查（ＵＳ）可提高诊断准确性．

Objective To study the computed tomographical (CT) features of cavemous transformation of the portal vein (CTPV) and to evaluate the diagnostic capability of CT. Materials and methods Ten patients with CTPV underwent abdominal precontrast and contrast CT. The CT findings were compared with DSA aam surgical findings. Results Characteristic features included loss of normal structure of the portal system and presence of multiple sinuous, periportal vascular structures which were enhanced during the portal phase. Transient difference in hepatic attenuation, seen as a homogeneous band, could be visualized in arterial phase, with the entire hepatic perenchyma once again becoming homogeneous in venous phase. Conclusion CT proves to be a reliable and useful modality for diagnosis of CTPV, supplying the necessary information for the clinical treatment planning. DSA and US examinations were necessary for atypical patients to improve the diagnostic capability of CT.