三维动态对比增强磁共振肝门静脉造影成像效果及解剖学分析

目的：探讨三维动态对比增强磁共振肝门静脉造影(3DDCEMRP)的成像质量并观测肝内肝门静脉的解剖和变异。方法：共进行61例门静脉3DDCEMRP检查，通过对MPV、LPV、RPV，SV及SMV显示情况和对门脉右支显示能力的分析，评价3DDCEMRP的成像质量。测量门脉系统各主要干支的径线并对门静脉的解剖和变异做分型，计算各型的构成比。结果：所有病例均完整显示门静脉主干及肝内4级以上分支。61次成像中，4例(6．6％)显示门脉主干呈三叉状，3例(4．9％)门脉主干先发出右后支，继续上行分为左支和右前支，2例(3．3％)门脉右前支起自左支，l例(1．6％)门脉右支缺如，其余5l例(83．6％)显示正常门脉分支。结论：肝内门脉变异并不少见，3D DCE MRP是一种有效、微创技术。能方便而清楚地显示肝内门脉的解剖和蛮异。

Study on 3D DCE MRP image quality and anatomy of portal vein system

Objective:To explore the showing ability of the three-dimensional dynamic contrast-enhanced MRP in displaying the anatomy and variations of intrahepatic portal vem. Methods:3D DCE MRP was performed in 61cases. Its image quality was evaluated by analyzing the demonstration of the portal venous system on 3D DCE MRP. The main branches of the portal venous system were measured and 61 3D DCE MRP of the portal system were analyzed. The normai anatomy of these venous systems was determined, the variations of the intrahepatic portal vein were classified and the percentage of each variation was calculated. Results:The main portal vein and its fourth-order branches had no disruption in all cases. Of the 61 patients , 4 (6.6%)had trifurcation, 3 (4.9%)had a right posterior branch originating from the main portal vein, 2 (3.3%)had a right anterior branch originating from the left portal vein, 1 (1.6% ) was short of the right portal vein. The remaining 51 (83.6%)patients had normai distributions of the intrahepatic portal vein. Conclusions:Variations of the intrahepatic portal vein branching are not rare, 3D DCE MRP is an effective and minimally invasive method to demonstrate the anatomy and variations of the intrahepatic portal vein clearly.