多层螺旋CT血管成像诊断胰源性与肝硬化门脉高压不同侧支循环的价值

目的探讨多层螺旋CT血管成像(MSCTA)评价肝硬化性及胰源性门脉高压不同侧支循环开放的价值.方法胰源性和肝硬化所引起的门脉高压患者各19例,均进行MSCT检查,并经后处理重建显示二者侧支循环.结果胰源性门脉高压常引起胃网膜右静脉(18/19)和胃冠状静脉曲张(15/19),较少有食管下段静脉曲张(2/19),无脐静脉开放;而肝硬化门脉高压较常见胃冠状静脉(19/19)、食管下段静脉曲张(15/19)和脐静脉开放(9/19),无胃网膜右静脉曲张.结论 MSCTA在诊断及鉴别诊断胰源性和肝硬化所引起的门脉高压不同侧支循环具有重要临床价值.

Diagnostic value of multi-slice CT angiography in different collateral pathways: pancreatic versus cirrhotic portal hypertension

Objective To assess the diagnostic value of multislice CT angiography in different collateral pathways caused by pancreatic and cirrhotic portal hypertension.Methods MSCT was performed in two groups of 19 patients with pancreatic and cirrhotic portal hypertension,respectively.The image reconstruction was made to display the patterns of collateral pathways of both groups.Results More commonly collateral pathways of pancreatic portal hypertension were right gastroepiploic vein(18/19) and gastric coronary vein(15/19),but none in umbilical vein;The collateral pathways of cirrhotic portal hypertension frequently occurred in the gastric coronary vein(18/19),lower esophagus(15/19) and umbilical vein(9/19),and never occurred in right gastroepiploic vein.Conclusion MSCTA is of great value in diagnosing different patterns of collateral pathways caused by pancreatic and cirrhotic portal hypertension.