MRI诊断门静脉血栓的价值

目的: 探讨MRI诊断门静脉血栓的价值.材料和方法: 回顾性分析经临床随访证实为4例门静脉血栓和32例肝细胞癌伴门静脉瘤栓的MRI平扫和多时相动态增强表现与诊断.结果: 3例血栓和32例瘤栓诊断正确、1例血栓误诊为瘤栓.4例血栓T1WI和T2WI呈高信号、用脂肪抑制后T1WI的高信号无变化,多时相动态扫描各期无增强;肝实质内未见肿块或结节.瘤栓T1WI呈低信号、T2WI高信号,动脉期轻至中度增强、门静脉期和延迟期增强的程度下降,31例瘤栓的肝实质内见单发或多灶肿块.结论: 门静脉血栓的MRI表现具有特征性,能准确鉴别血栓和瘤栓.

The Diagnostic Value of MR Imaging for Portal Vein Thrombosis

Purpose: To assess the diagnostic value of MR imaging for portal vein thrombosis (PVT). Materials and Methods: The images of nonenhanced and multiphase gadolinium-enhanced MR imaging in 4 patients with clinical confirmed PVT and in 32 hepatocellular carcinoma patients with portal vein tumor thrombus (PVTT) were reviewed retrospectively. Results: Three PTV and 32 PVTT were diagnosed correctly. One PVT was mistaken for PVTT. Four PVT were hyperintense on T1WI and T2WI, and the high signal intensity was not suppressed after using fat saturation. Four PVT showed no enhancement during arterial phase, portal venous phase and delayed phase after administration of Gd-DTPA and there was no nodule or mass detected in the liver. PVTT in thirty-two hepatocellular carcinomas demonstrated hypointensity on T1WI and hyperintensity on T2WI and showed slight or moderate enhancement during arterial phase, and wash out during portal venous phase and delayed phase, and solitary or multiple masses of 31 cases detected in the liver. Conclusion: MR imaging can reveal the characteristic findings of PVT and differentiate PVT from PVTT.