MSCT对门静脉海绵样变患者门静脉性胆道病的评价研究

MSCT in Patients with Portal Vein Sponge and Portal Vein Sex Evaluation Study of Biliary Tract Disease

目的:探讨多排螺旋CT血管成像(MSCT)对门静脉海绵样变患者门静脉性胆道病的评价效果。方法:选取在本院就诊的1例原发性门静脉海绵样变(PCTPV)合并门静脉性胆道病患者作为研究对象。采用多排螺旋CT行平扫、肝动脉期及门脉期扫描,总结患者MSCT影像特征。结果:本例患者门静脉胆支、门静脉胃支、胰十二指肠上静脉和脐旁静脉均可显示。患者MSCT扫描印象诊断:门静脉海绵样变性并门静脉性胆道病,影像特征:肝内外胆管略扩张,门静脉肝内分支细小,门脉期肝脏灌注较差。胆囊壁及胆总管管壁增厚,呈延时强化。胆囊底及周围可见迂曲扩张的血管影。肝门水平门静脉大分支或其主干缺如或闭塞,并见团状纡曲扩张的畸形血管;门静脉走行区结构紊乱,门静脉及肠系膜上静脉呈海绵样变性,周围多发侧枝循环形成,呈长椭圆形分布,肠系膜上静脉内可见不规则充盈缺损影,管壁可见点片状致密影。结论:门静脉海绵样变性并门静脉性胆道病患者MSCT影像具有一定特征性,对于该病诊断及评价具有重要指导作用。

Objective： To evaluate the effectiveness of multislice spiral CT angiography （MSCT） in the diagnosis of portal vein biliary disease （CAD） in patients with portal vein cavernous transformation. Methods： One ease of primary portal vein cavernous degeneration （PCTPV） with portal vein biliary disease was selected as the study subject in our hospital. Multi-slice helical CT scan, hepatic arterial phase and portal phase scan were used to summarize the characteristics of MSCT images. Results： The portal vein branch, portal vein branch, superior pancreaticoduodenal vein and umbilical vein can be displayed in this patient. Patients with MSCT scan impression diagnosis： portal vein cavernous degeneration and portal vein biliary tract disease, imaging features： a little expansion of intrahepatic bile duet, portal vein intrahepatic small, portal perfusion of liver poor. Gallbladder wall and common bile duct wall thickening, was delayed to strengthen. Gallbladder bottom and around the tortuous expansion of the blood vessels can be seen shadow. Portal vein and the main branch of the absence or occlusion of the trunk, and see the expansion of the mass of tortuous blood vessels; portal vein disorder in the running area, portal vein and superior mesenteric vein showed spongiform degeneration, the surrounding multiple collateral circulation, shaped distribution, the superior mesenteric vein filling defect filling the shadow, the tube wall can be seen point dense sheet shadow. Conclusion： MSCT images of portal vein cavernous degeneration and portal vein biliary disease have certain characteristics, which are important for the diagnosis and evaluation of portal vein graft disease.