肝细粒棘球蚴病下腔静脉肝静脉CT成像的评估价值

Value of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis

目的探讨使用CT成像评估肝细粒棘球蚴病病灶与下腔静脉、肝静脉关系的准确性。方法 100例肝细粒棘球蚴病患者行腹部CT三期扫描,得到下腔静脉、肝静脉三维重建图像,观察棘球蚴病病变与下腔静脉、肝静脉的关系,将结果与术中结果对比,分析使用CT成像评估肝细粒棘球蚴病病灶侵犯下腔静脉、肝静脉的可靠性。结果 CT成像评估血管推移、伴抱球征、界限不清楚、血管狭窄等与术中所见一致。有4例患者CT成像判断为病灶与下腔静脉界限清楚,而术中示病灶与血管有一定黏连。对于有血管狭窄判断为受侵犯的结果中,有3例为过度诊断。结论肝静脉、下腔静脉CT成像能清晰显示肝棘球蚴囊肿与肝静脉、下腔静脉的空间位置关系。

Objective To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis. Methods A total of 100 patients with hepatic cystic echinococcosis were given triple-phase abdominal CT scan, and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed. Results The compression displacement, half-globular, no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordanee with the real situation under the surgical sight. However, four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments. Conclusion The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.