门静脉瘤的CT和MRI诊断

Diagnosis of CT and MRI of Portal Venous Aneurysm

目的探讨门静脉瘤(PVA)在多层螺旋CT(MSCT)、MRI中的表现。材料和方法搜集经MSCT、MRI平扫和动态增强扫描诊断为PVA15例患者的资料,采用多平面重组(MPR)、容积再现重组(VR)等进行血管重建,分析其表现。结果 15例PVA中,11例行CT检查,4例行MRI检查。MRI平扫呈血管流空信号,CT平扫表现为等或稍低密度,动态增强扫描动脉期无强化,门静脉期和延迟期呈持续血管样强化。肝内型5例,发生于门静脉左支3例,右支2例,1例合并肝动脉-门静脉瘘,1例合并门静脉-肝静脉瘘。肝外型8例,发生于门静脉主干4例,肠系膜上静脉1例,脾静脉3例。混合型2例,1例发生于脾静脉和门静脉右前支,1例发生于网膜静脉和门静脉左支。3例PVA附壁血栓形成。结论 CT、MRI动态增强扫描结合血管后处理重建,能准确诊断PVA。

Objective To evaluate the manifestations of portal venous aneurysm （PVA） of MSCT and MRI.Materials and Methods Data of 15 patients, which were diagnosed PVA by MSCT and MRI plain scanning and dynamic enhanced scanning, were collected and analyzed through multiple planar recombinations （MPR）, volume rendering and so on. Results For those 15 patients of PVA, 11 ones were examined by CT while the rest were checked by MRI. There is no signal in MRI plain scanning. In CT plain scanning, signals of densities are equal or little lower than normal. In the process of dynamic enhanced scanning showed no enhancement in arterial phase, portal venous phase and delayed phase was persistent in vascular enhancement.There are five intrahepatic cases, with three originated in the left branched of portal vein, and two cases in the right branched. Within these five cases, one is portal vein-hepatic artery fistulae, and another is hepatic artery - portal vein fistulae. There are 8 extrahepatic cases, with 4 cases originated in main portal vein, 1 case in venae mesenterica superior, 3 cases in splenic vein. There is mixed type in 2 cases, with 1 cases originated in the splenic vein and portal vein right anterior branch, and 1 cases originated in retinal vein and left portal vein. There are 3 cases of PVA mural thrombosis.Conclusion Using CT and MRI dynamic contrast enhanced scanning together with vascular reconstruction after processing, accurate diagnosis of PVA can be gained.