320排CT上腹部CTA在TIPSS术后随访中的应用

Application of 320 row CT upper abdominal CTA in the follow up of TIPSS therapy

目的探讨320排多层螺旋CT上腹部CT血管造影(CTA)在经颈静脉肝内门-体静脉分流术(TIPSS)术后随访中的应用价值。方法 21例TIPSS术后患者行上腹部CTA检查,采用多平面重建、容积再现、最大密度投影及曲面重建(CPR)技术进行图像后处理,判断术后支架位置及通畅情况,获得门静脉图像成像最佳时像。结果 21例患者中,3例(14.29%)支架闭塞,1例(4.76%)支架狭窄,曲面重建图像能清晰显示支架腔内低密度血栓影;17例(80.95%)患者TIPSS术后未出现支架狭窄或闭塞,CPR图像显示支架内造影剂充盈完全,未见低密度血栓形成。门静脉显示最佳时像为45s。结论 320排多层螺旋CT上腹部CTA检查能够清晰显示支架位置及通畅情况,应作为TIPSS术后随访复查的首选手段。

Objective To evaluate the value of 320 row CT upper abdominal computed tomography angiography （CTA） in the follow up of transjugular intrahepatic portosystemic shunt（TIPSS） .Methods 21 cases after TIPSS therapy underwent upper ab-dominal CTA .Post-processing images ,including MPR ,VR ,MIP ,and CPR ,were used to determine the position and patency of the stent .The best images of the portal veins were obtained .Results Among the 21 cases ,CPR image clearly demonstrated endovascu-lar stent thrombosis in 3 cases（14 .29% ） with stent occlusion and 1 case（4 .76% ） with stent stenosis ;there were no stent stenosis or occlusion in 17 cases（80 .95% ） ,their CPR image showed the contrast agent was filled completely in the stent and no low-density thrombosis was found .The best phase of the portal vein was 45 s .Conclusion 320 row CT upper abdominal CTA can clearly dis-play the stent position and patency situation in patients ,therefore ,should be regarded as the first choice for the follow-up of patients after TIPSS therapy .