多层螺旋CT对胰源性区域性门静脉高压的诊断价值（附42例报道）

目的 分析胰源性区域性门静脉高压(pancreatogenic segmental portal hypertension,PSPH)的多层螺旋CT(MSCT)表现,探讨MSCT对该病的诊断价值.方法 使用16排螺旋CT对42例PSPH患者行上腹部CT平扫及增强扫描,采用图像后处理技术显示脾静脉及侧枝血管情况.结果 孤立性脾静脉阻塞30例,其侧支血管食管静脉(9.5%)、胃冠状静脉(76.19%)、胃短静脉(85.71%)、胃网膜静脉(95.24%)、胃结肠干(23.81%)曲张;非孤立性脾静脉栓塞12例,其中伴肠系膜上静脉阻塞8例,其属支胃结肠干(19.05%)、结肠右上静脉(16.67%)、结肠中静脉(14.29%)、胰十二指肠前上静脉(19.05%)有不同程度曲张.伴门静脉海绵样变5例.结论 MSCT对PSPH的脾静脉阻塞及其胃周迂曲扩张的侧枝静脉显示具有重要价值.

Diagnostic Value of Multi-slice CT in Pancreatogenic Segmental Portal Hypertension and a report of 42 cases

Objective To analyze MSCTfeatures of PSPHand to evaluate the value of MSCT in clinical settings and imaging diagnosis of PSPH.Methods A 16-detector row spiral CT scanner was used to perform plain and muti-phase contrast enhanced abdominal scanning in 42 patients with PSPH.Various image post-processing techniques were applied to depict abnormal splenic vein and the collateral vessels of PSPH.Results In 30 cases with isloated splenic vein occlusion,esophageal vein(EV,9.5%),coronary gastric vein(CGV,76.19%),short gastric vein(SGV,85.71%) gastroepiploic vein(GEV,95.24%) and gastrocolic trunk(GCT,23.81%) were varicose and dilated,respectively.In 12 non-isloated splenic vein occlusion,associated with 8 cases SMV occlusion,other collateral veins such as gastrocolic trunk(GCT,19.05%),the right superior colic vein(RSCV,16.67%),middle colic vein(MCV,14.29%) and anterior superior pancreaticoduodenal vein(ASPDV,19.05%) were seen as well.Meanwhile 5 cases assoicated with cavernous transformation of portal vein.Conclusion MSCT and image post-processing techniques are of great value for the diagnosis of PSPH in Splenic vein occlusion and collateral vessels around.