磁共振门静脉成像在门脉高压症外科诊疗中的应用

Application of MR portography in surgical diagnosis and therapy of portal hypertension

目的 :评价磁共振门静脉成像在门脉高压症外科诊疗中的应用价值。方法 :对 32例门脉高压症病人的磁共振门静脉造影图像进行分析并与手术结果进行对比。结果 :32例病人中的 30例显示了清晰的门静脉图像 ,2例显示不清者手术证实为门静脉血栓形成或海绵样病变。全部病例的胃左静脉都呈不同程度的扩张、迂曲。 1例肠系膜上静脉显示有狭窄者也经手术证实。造影过程中也可见到萎缩的肝和增大的脾。结论 :磁共振门静脉成像术是评价门静脉的一项快速无创的技术 ,可提供完整清晰门静脉图像 。

Objective:To evaluate the availability of MR portography(MRP) in surgery of portal hypertension. Methods: MRP was analyzed and compared to the findings of the operations in 32 patients with portal hypertension. Results: Of the 32 cases, 30 showed clear portographs, while 2 with obscure imaging had thrombosis or spongioid lesion of the portal vein. The left gastric vein of all cases became dilated and tortuous to a various degree. Stricture of the superior mesenteric vein in one case was confirmed during operation. At the same time, atrophy of the liver and enlargement of the spleen were also observed in MRP. Conclusion: MRP is a rapid and noninvasive technique for assessment of portal venous system. It can provide an intact and clear portograph, which facilitates the selection of a better operative modality and approach.