门静脉瘤的MSCT血管成像诊断价值

Value of MSCT Angiography in the Diagnosis of Portal Vein Aneurysm

目的:探究MSCT血管成像对门静脉瘤的诊断价值,以提高认识。方法:回顾性分析24例行MSCT血管成像检查的门静脉瘤患者的临床及影像资料,利用MPR、MIP、VR等技术对图像进行处理,记录患者的性别、部位、形态、门脉系统、并发症等情况,分析其相关性。结果:24例均为单发,其中脾静脉与肠系膜上静脉交汇处(CNF)14例,门静脉主干(MPV)2例,门静脉左支(LBP)4例,门静脉左右支分叉处(PVB)4例;16例呈囊状扩张,8例呈梭形扩张;4例合并海绵样变性,2例合并门静脉栓子形成,2例合并腹主动脉瘤;16例合并门静脉高压。门静脉瘤不同性别的发病部位分布差异有统计学意义(χ2=12.176,P<0.05),男性患者中以脾静脉与肠系膜上静脉交汇处居多(85.7%);门静脉瘤不同形态的并发症情况分布差异有统计学意义(χ2=6.000,P<0.05),门静脉瘤合并并发症者均为囊状扩张;门静脉瘤发病部位与门静脉高压有显著关系(χ2=11.143,P<0.05),合并门静脉高压者以脾静脉与肠系膜上静脉交汇处发病居多(62.5%)。结论:门静脉瘤虽少见,但其有一定特征性,MSCT血管成像具有很好的诊价值。

Purpose： To explore the value of MSCT angiography in the diagnosis of portal vein aneurysm, in order to improve the understanding of this disease. Methods： The MSCT angiography finding of 24 cases portal vein aneurysm were analyzed retrospectively. The CT images were processed with multiple planer reformation （MPR）, maximum intensity projection （MIP）, and volume rendering （VR）. The gender of the patients, the location, shape, size of the lesions was observed and recorded, and the correlation between them and the presence of complications was analyzed. Results： The findings of CT were saccular or fusiform aneurysmal dilatation of portal vein, greater than the adjacent portal vein. All cases appeared as solitary lesions. There were 16 extrahepatic cases and 8 intrahepatic cases, 14 cases of them were located at the splenomesenteric venous confluence, 2 cases at the main portal vein, 4 cases at the left portal vein and portal venous branch respectively; 16 cases of them were with cystic dilation and 8 cases with fusiform enlargement; 16 cases were with portal hypertension. The differences in the distribution of location of portal vein aneurYsm were with statistical significant （X^2=12.176,P〈0.05）, the location of splenomesenteric venous confluence was commonly observed in male patients （85.7%）; The differences in the distribution of different shapes portal vein aneurysm with complications were with statistical significant （X^2=6.000,P〈0.05）, all the portal vein aneurysm with cystic dilation were with complications; The location of portal vein aneurysm was strongly associated with portal hypertension （X^2= 11.143, P〈0.05）, the portal vein aneurysm located at the splenomesenteric venous confluence was commonly observed with portal hypertension （62.5%）. Conclusion： Portal vein aneurysm is rare, but has certain characteristics; The MSCT plays an important role in thediagnosis.