静脉瘤的影像学诊断

Imaging characteristics of venous aneurysm

目的分析静脉瘤的影像学特征,探讨静脉瘤的影像学诊断价值。方法收集德阳市人民医院2012年1月至2017年12月间30例就诊患者各部位静脉瘤的完整CT和MR动态增强扫描资料,通过多平面重建(MPR)、最大密度投影(MIP)、容积再现技术(VR)技术分析静脉瘤及并发症影像学特征。结果瘤体位置:11例位于门静脉,6例位于腔静脉,5例位于颈静脉,3例位于肺静脉,2例位于肾静脉,1例位于大脑大静脉(Galen瘤),1例位于肝静脉,1例起源于位于腹膜后静脉;瘤体形态(局限性梭形或囊状扩张):21例呈囊状,9例呈梭形;合并症及伴发畸形:12例瘤内合并血栓,9例瘤壁钙化,2例门静脉瘤合并肝内门静脉分支变异,1例肝中静脉瘤合并门静脉-肝静脉瘘,2例上腔静脉瘤瘤体近心端狭窄,1例下腔静脉瘤合并右肾发育不良,1例下腔静脉瘤合并腹膜后肿瘤。结论静脉瘤多发生于静脉分叉或交汇处,MRI及CT动态增强扫描及后处理技术可以直观显示静脉瘤,载瘤静脉及其合并症,为临床治疗提供精确的解剖学依据。

Objective To analyze imaging characteristics of venous aneurysm. Methods Image data of 30 patients of venous aneurysms who underwent CT and/or MR examination in Deyang People's Hospital between January, 2012 and December, 2017 were collected. The raw data were post-processed with multiplanar reconstruction (MPR), maximum intensity projection (MIP), and volume rendering (VR) techniques. The imaging features of venous aneurysms and its complications were analyzed. Results (1) Location of the lesions: 11 cases located in the portal vein, 6 in the vena cava, 5 in the jugular vein, 3 in the pulmonary vein, 2 in the renal vein, 1 in the great cerebral vein (aneurysm of Galen vein), 1 in the hepatic vein, and 1 in the retroperitoneal vein.(2) The morphologic features of venous aneurysms: 21 lesions appeared as cystic and 9 cases as fusiform contour.(3) Complications and other variations: 12 cases was complicated with thrombus, 9 cases with a calcified wall, 2 cases with variations of portal vein, 1 case with hepatic vein-portal venous fistula, 2 cases with proximal stenosis of superior vena cava, 1 case with dysplasia of the right kidney, 1 case with a retroperitoneal tumor. Conclusion Venous aneurysms occur mostly in venous bifurcation or intersection. Dynamic enhanced MRI and CT with post-processing technique can intuitively visualize venous aneurysm, parent venous and its complications or other variations as well, which can provide an accurate anatomical material for the clinical optimization of the treatment.