64层螺旋CT对门静脉海绵样变的诊断价值简

目的分析门静脉海绵样变（CTPV）的64层螺旋CT表现和特征，探讨64层螺旋CT对该病的诊断价值。方法使用对6例CTPV患者，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异常的门静脉及侧支血管情况。结果CTPV的64层螺旋CT平扫示门静脉结构不清，肝门区可见多发的结节状软组织影。本组全部病例均见门静脉主干及其分支闭塞和（或）狭窄，正常门静脉系统结构消失，门静脉走行区结构紊乱，表现门静脉主干和（或）其分支因栓子闭塞和（或）狭窄5例，门静脉管腔增宽，内可见低密度充盈缺损1例，门-门侧支血管6例，胆管周围静脉丛曲张3例，胆囊静脉丛曲张2例，胃左静脉曲张5例。门一体侧支血管6例，食管胃底静脉曲张4例，腹膜后静脉曲张2例、脾胃-肾静脉分流3例。增强扫描肝实质灌注异常2例，胆囊、胆管壁增厚2例，合并管腔狭窄5例。结论64层螺旋CT及图像后处理系统对CTPV诊断具有重要价值，门静脉栓塞及其周围迂曲扩张的侧支静脉为其特征性表现。

The Diagnostic Value of Cavernous Transformation of Portal Vein on 64-Slice Spiral CT

Objective Analysis the characteristics ofportat vein sponge wpe changes （CTPV） on 64 screw CT, and to explore the diagnostic value of CTPV on 64 screw CT. Methods 6 patient with CTPV nnderwent the routine and dynamic enhancenlent scan of abdomen, then the abnormal portal venous and collateral circulation were display by image post-processing technologies including nmlti-planar reconstruction （MPR）, maximum intensity projection the （MIP）, and volmne reproduction （VR）. Results the portal vein structure was unclear and nmltiple nodular soft tissue shadows were shown on CTPV. The stenosis or occlusion of portal vein and its branches, the normal portal vein system structure disappeared, disorganization of the area of portal vein on the study group The stenosis or occlusion of portal vein and its branches due to the embolus （Scases）, the increased portal vein with low density, filling defect（1 cases）, collateral circulation（6cases）, around bile duct vein varicosity（3cases）, gallbladder vein varicosity（2cases）, stomach left varicosity, （5cases）. Gate-body lateral support blood vessel （6cases）, esophagus fundus ventriculi varicosity（4 cases）, retroperitoneal varicosity （3cases）, spleenstomach - kidney vein diverges（3cases）. Enhancement scanning parenchyma of liver irrigation unusual （2cases）, gallbladder and bile duct wall accunmlation（2cases）, merge lmnen narrow（Scases）. Conclusinos 64-slice spiral CT and image post-processing system for CTPV diagnosis has great value, the collateral circulation due to portal vein embolization and expansion of collateral veins was its character.