多层螺旋CT在TIPSS术后随访中的应用研究

目的:探讨多层螺旋CT血管成像(MSCTA)在TIPSS术后随访中的价值.方法:17例TIPSS术后患者(共19支支架)行MSCT门静脉成像,采用最大密度投影(MIP)、曲面重组(CPR)和容积再现(VR)技术进行图像后处理.17例中6例进行了DSA检查,11例得到了病理标本.将MSCTA表现与病理或DSA结果进行对照分析.结果:MSCTA发现19支支架中完全闭塞3支,支架狭窄4支,肝静脉端狭窄3支,同时伴有支架内和肝静脉端狭窄3支,未见明显异常6支.与DSA或病理对照,CTA诊断支架狭窄的诊断符合率和特异度分别为90%和83.3%,诊断支架闭塞的诊断符合率和特异度分别为100%和94.1%.结论:MSCTA可准确显示TIPSS术后支架的通畅性,为外科提供了一种无创的随访和筛查的手段.

Multislice CT in the Evaluation of Transjugular Intrahepatic Portosystemic Shunt

Objective:To evaluate 16 multi-slice spiral CT angiography in the follow up of transjugular intrahepatic portosystemic shunt (TIPSS).Methods:17 patients with 19 TIPSS stents underwent multi-slice spiral CT angiography and MIP,VR,CPR were performed for each stent.Portography was performed in 6 patients and 11 patients underwent liver transplantation.Results of CT angiography and portography or pathology were compared.Results:CTA had the sensitivity and specificity of 90% and 83.3% in detecting stent stenosis,and 100% and 94.1% in detecting occlusion.Conclusion:Multi-slice CT angiography was a noninvasive screening and follow up method for surgeon and can provide diagnostic images of normal and abnormal TIPSS with accurate demonstration of the stent stenosis and occlusion.