儿童门静脉海绵样变的血管造影诊断及其临床意义

Children′s cavernous transformation of the portal vein: angiographic features and the impact on surgical treatment

目的 探讨儿童门静脉海绵样变 (CTPV)的间接门脉造影诊断及其临床意义。方法回顾性分析了 6例经超声诊断及手术证实的门静脉海绵样变患儿的间接门脉造影血管造影图像 ,观察其特征性的血管造影表现 ,并对其指导临床治疗意义进行了评价。结果 6例中 5例清楚显示门脉主干近肝门处阻断 ,代之以肿块样迂曲血管并在其周围形成特征性向肝内放射状的侧支血管影像 ,以及离肝性侧支循环静脉。 6例血管造影均能对与分流或断流手术有关的血管解剖提供准确信息。结论 儿童CTPV具有特征性的血管造影表现 。

Objective To study the arterial portography features and the impact on surgical treatment of children′s cavernous transformation of the portal vein (CTPV). Methods Angiographic findings of the arterial portography of 6 children with CTPV and its impact on surgical treatment were retrospectively analyzed. Results Abrupt occlusion of the portal vein at the porta hepatis was revealed in 5 out of 6 cases, and a masslike network of intertwined veins around the porta hepatis and many small irregular veins radiating from the network to the liver were demonstrated. Both hepatopetal and reverse flow of collateral venous pathways were defined. Valuable information of correlative vessels for surgical treatment was obtained from all 6 angiographic findings. ConclusionChildren′s CTPV have very characteristic angiographic findings, which can be very helpful for surgical management.