MSCT诊断门静脉性胆道病

MSCT in diagnosis of portal biliopathy

目的探讨MSCT诊断门静脉性胆道病(PB)的应用价值。方法回顾分析122例PB患者的临床及CT资料。CT采用常规平扫及多期增强扫描,68例扫描后将薄层重建图像传至三维工作站,采用MPR、CPR、MIP、VR、MinIP等观察门静脉及胆道系统,详细分析其影像学表现及特点,并由2名资深影像学医师做出诊断。结果 PB特征性CT表现为门静脉栓子形成或正常结构消失,门静脉区见多发呈串珠样分布侧支血管,包绕肝内外胆管,肝内外胆管变形、狭窄及胆管壁增厚;间接表现包括胆囊增大和(或)胆囊静脉曲张及胆道结石,脾大,脾静脉、食管胃底静脉不同程度曲张等。结论 MSCT是诊断门静脉性胆道病的准确可靠的影像学方法。

Objective To investigate the value of MSCT in diagnosis of portal biliopathy （PB）. Methods Clinical data and CT findings of 122 patients with PB were retrospectively analyzed. All patients underwent conventional CT scanning and multi-phase enhanced scanning. The images of 68 patients were taken to 3D workstation, and then were postprocessed with MPR, CPR, MIP, VR, MinIP and so on, and the portal vein and biliary system were observed. The final diagnosis was given by two experienced radiologists. Results Portal vein emboli formed, or the normal structure of the portal vein disappeared in PB patients. Many collateral vessels, which were like string-of-beads, existed around the intrahepatic and extrahepatic bile duct in portal area. The intrahepatic and extrahepatic bile duct deformated and stenosed, and the wall thickened. Indirect signs included gallbladder enlarged, cystic vein varicose, and （or） bile duct stones, splenomegaly, splenic, esophageal and gastric varices, etc. Conclusion MSCT is an accurate and reliable method for noninvasive diagnosis of portal biliopathy.