摘要
目的观察CT门静脉成像(CTPV)用于TIPS治疗门静脉高压(PH)的价值。方法纳入267例接受TIPS治疗的肝硬化失代偿期PH患者,分析其治疗前CTPV资料,观察肝内有无肿瘤、肝静脉与门静脉的相对空间位置、门静脉通畅度,曲张静脉分型、程度及有无异常分流道等。结果在267例中,23例合并肝脏肿瘤,79例存在门静脉血栓,14例门静脉海绵样变性。门静脉分叉部、左支、右支裸露者占比分别为13.11%(35/267)、5.62%(15/267)及2.25%(6/267),肝静脉与门静脉之间的垂直距离为(22.83±9.56)mm,前后距离为(28.23±10.06)mm。术前增强CT及CTPV显示227例胃左静脉曲张、111例胃后/胃短静脉曲张及72例自发性门体静脉分流,其与术中DSA的一致率分别为98.24%(223/227)、85.59%(95/111)及100%(72/72)。264例TIPS成功(264/267,98.88%),对其中58例采用辅助手段穿刺门静脉成功。结论CTPV对于指导实施TIPS治疗PH具有重要价值。
Objective To observe the value of CT portal venography(CTPV)for TIPS in treating portal hypertension(PH).Methods Totally 267 PH patients with decompensated cirrhosis underwent TIPS treatment.Before treatment,CTPV was performed to evaluate whether there was liver cancer,the spatial positive relationship of hepatic vein and portal vein,the patency of portal vein,the classification and degree of varices,as well as the presence or not of abnormal shunt in patients with PH before TIPS.Results Among 267 patients,23 were found with liver tumors,79 with portal vein thromboses,14 with cavernous degeneration of portal vein.The ratio of exposed bifurcation,left and right branches of the portal vein was 13.11%(35/267),5.62%(15/267)and 2.25%(6/267),respectively.The vertical and the anterior-posterior distance between the hepatic vein and the portal vein was(22.83±9.56)mm and(28.23±10.06)mm,respectively.There were 79 patients with portal vein thrombosis before operation,including 14 patients with cavernous degeneration of portal vein.Before TIPS procedure,enhanced CT and CTPV showed gastric coronary varices in 227 cases,gastric short/retrogastric varices in 111 cases and spontaneous portal systemic shunt in 72 cases,with the coincidence rate of CTPV before TIPS and DSA during TIPS procedure of 98.24%(223/227),85.59%(95/111)and 100%(72/72),respectively.TIPS was successfully completed in 264 cases(264/267,98.88%),and assisted punctures were performed in 58 cases.Conclusion CTPV played an important role in guiding TIPS for treating PH.
作者
张子晨
黄金涛
沈健
姚飞荣
赵梓乐
李婉慈
仲斌演
张帅
朱晓黎
ZHANG Zichen;HUANG Jintao;SHEN Jian;YAO Feirong;ZHAO Zile;LI Wanci;ZHONG Binyan;ZHANG Shuai;ZHU Xiaoli(Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Gastroenterology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《中国介入影像与治疗学》
北大核心
2023年第3期129-133,共5页
Chinese Journal of Interventional Imaging and Therapy
基金
江苏省社会发展面上项目(BE2021648)。
