螺旋CT诊断肝癌合并门静脉海绵样变性及其在介入治疗中的意义

目的分析门静脉海绵样变性（CPTV）患者的CT表现和特征,探讨螺旋CT诊断该病的价值及临床意义。方法回顾性分析28例经彩色多普勒、MRI或手术证实的CTPV,所有病例均行上腹部螺旋CT平扫及动态增强扫描。结果肝癌合并CTPV的螺旋CT主要表现为：门静脉主干或其分支扩张增粗,门静脉走行区可见迂曲扩张、紊乱的静脉血管影;肝实质动脉期一过性异常灌注;显示原发病灶。结论肝癌合并CTPV有特征性螺旋CT表现,螺旋CT可以诊断门静脉海绵样变性。正确认识其CT表现对肝癌的介入治疗具有重要指导意义：对于肝癌合并门静脉癌栓患者,在有CTPV形成时,经皮肝动脉栓塞治疗是安全、可行的。

Spiral CT and its clinical significance for the diagnosis of cavernous transformation of portal vein in hepatocellular carcinoma patients

Objective To study the clinical significance of CT in the diagnosis of cavernous transformation of portal vein（CPTV）.Methods 28 patients with cavernous transformation of portal vein confirmed by color Doppler sonography,MRI or surgery were included in the study.Plain and enhanced spiral CT were performed for all patients.Results Patients with cavernous transformation of portal vein had shown features such as;expanded main portal vein or its branch,mushy circu-lating vein,transient abnormal perfusion in liver parenchyma at arterial phase,and primary lesion under spiral CT examina-tion.Conclusion Conclusion Spiral CT findings are characteristic for the diagnosis of CTPV.Transcatheter arterial embo-lization is safe and effective for hepatocellular carcinoma patients with CTPV.