MSCT在小儿门静脉海绵样变术前及术后的应用价值

目的 探讨MSCT在小儿门静脉海绵样变(CTPV)术前诊断及术后疗效评价中的应用价值.方法 收集本院经手术证实为CTPV患儿11例,术前均行MSCT平扫与增强扫描,术后均行超声或MSCT检查.结果 11例患儿术前CT扫描均显示脾不同程度增大,平扫可见肝门区异常软组织团块影,增强扫描示门静脉主干狭窄消失,肝门部出现蚯蚓状血管团,肝内左侧分支和/或右侧分支被多发集聚的血管取代(Ⅱ型).11例患儿均行肠系膜上静脉-门静脉左支旁路分流术(Rex术)手术顺利,术后随访2～20个月,影像学检查示9例患儿吻合口通畅,2例患儿吻合口狭窄.结论 小儿CTPV的MSCT表现具有一定特征性,MSCT在小儿CTPV术前诊断及术后疗效评价中具有重要意义.

Application value of MSCT in preoperative diagnosis and postoperative evaluation in children with cavernous transformation of the portal vein

Objective To evaluate the application value of MSCT in preoperative diagnosis and postoperative evaluation in children with cavernous transformation of the portal vein (CTPV).Methods 11 children diagnosed with CTPV by surgery were included in this study in our hospital.All patients underwent both plain and enhanced MSCT scans before surgery,and ultrasound or MSCT scan after surgery.Results In all 11 cases,preoperative CT showed different degrees of splenomegaly and the plain CT showed abnormal soft tissue mass in the hepatic hilar area.Enhanced CT showed stenosis or occlusion of portal vein trunk,earthworm-like blood vessels in the hilar region,and that the left and/or right branch of intrahepatic portal vein were replaced by multiple densely-distributed blood vessels (typeⅡ). Superior mesenteric-intrahepatic left portal shunt (Rex surgery)was performed in all 11 cases with successful results.All patients were followed up for 2-20 months after surgery.Imaging examinations showed anastomotic patency in 9 cases and stenosis in 2 cases.Conclusion MSCT findings of CTPV in children have certain characteristics.MSCT plays an important role in preoperative diagnosis and postoperative evaluation of CTPV in children.