多层螺旋CT门静脉成像对门静脉高压侧枝血管的诊断价值

目的分析肝硬化门静脉高压侧枝循环的多层螺旋CT门静脉成像（MSCTP）表现,探讨MSCT门静脉成像对该病的诊断价值。方法对63例肝硬化门静脉高压患者,使用16层螺旋CT行上腹部CT平扫、动态增强扫描,采用多平面重组（MPR）、最大密度投影（MIP）、容积再现（VR）等图像后处理技术显示门静脉高压侧枝血管情况。结果食管下段静脉曲张56例,食管旁静脉曲张23例,胃冠状静脉曲张40例,8例伴副脐静脉侧枝循环开放;腹壁静脉丛曲张呈蛇头征1处;6例脾肾静脉分流;4例胃-肾上腺分流;5例伴门静脉海绵样变。结论MSCTP可较好地显示各类门静脉高压侧枝,对其作出正确诊断,对临床选择治疗方法有重要的意义。

Diagnostic value of multi-slice CT petrography in collateral vessels in patients with liver cirrhosis and portal hypertension

Objective To analyze multi-slice CT petrography（MSCTP）features of collateral vessels in patients with liver cirrhosis and portal hypertension and evaluate it′s diagnostic value.Methods A 16-detector row spiral CT scanner was used to perform plain and muti-phase contrast enhanced abdominal scan in 63 patients with liver cirrhosis and portal hypertension.Various image post-processing techniques such as MPR,MIP,VR,were applied to depict portal hypertension and the collateral vessels.Results MSCTP findings included lower esophageal varices in 56 cases,paraesophageal varices in 24 cases,coronary gastric vein carices in 40 cases,reopened paraumbilical vein in 8 cases,abdominalwall varices and caputmedusa sigh in 1 cases,splenorenal shunts in 6 cases,gastrorenal shunts in 4 cases,portal vein cavernous transformation in 5 cases.Conclusion MSCTP can demonstrate much more clearly the collateral vessels in patients with cirrhosis and portal hyper-tension.Exact diagnosis of disease may play a significant role in making a clinical treatment plan.