三维动态增强磁共振门脉成像在门脉高压症的应用价值

目的评价三维动态增强磁共振门脉成像在门脉高压症外科诊疗中的应用价值。方法对22例门脉高压症患者（门脉高压组）与15例非门脉高压症患者（对照组）的增强磁共振门静脉造影图像进行对照分析。结果 37例中36例（门脉高压组21例,对照组15例）显示清晰的门静脉图像。肝内门脉灌注情况依据Nordlinger分级,肝硬化组Ⅰ级0例,Ⅱ级3例,Ⅲ级16例,Ⅳ级2例,而对照组分别为,12、2、1、0例,两组间分布有显著性差异（P〈0.05）。门脉主干（PV）、脾静脉（SV）及肠系膜上静脉（SMV）管径的测值（cm）：门脉高压组分别为1.64±0.13、1.35±0.21、1.28±0.16,对照组为1.14±0.12、0.95±0.10、0.83±0.12,两组间有显著性差异（P〈0.05）。结论三维动态增强磁共振门脉成像是评价门静脉高压症的一项快速无创的技术,有助于外科医生选择正确的手术方法和手术入路。

Value of three dimensional dynamic contrast enhanced MR portovenography in portal hypertension

Objective To assess the availability of three dimensional dynamic enhanced MR portovenography（3D-DCE-MRPVG） in visualizing portal hypertension.Methods 3D-DCE-MRPVG data of 22 patients with portal hypertension（HBP group） and 15 cases with no portal hypertention（control group） were analyzed.Results Portal venous system was visualized well in 36 of 37 cases（HBP group 21,control group 15）.The diameter（cm） of portal venous trunk,spleen vein and superior mesenteric vein were 1.64±0.13,1.35±0.21,1.28±0.16 for HBP group,while 1.14±0.12,0.95±0.10,0.83±0.12 for control group,respectively.There was statistical difference between 2 groups（P0.05）.According to Nordlinger classification standard,0 case was classified to grade Ⅰ,3 cases to grade Ⅱ,16 cases to grade Ⅲ,2 cases to grade IV for HBP group,while 12,2,1 and 0 cases for control group respectively.The difference between two groups were statistically significant（P0.05）.Conclusion 3D-DCE-MRPVG was of great value for visualization of portal venous system and is helpful for surgery.