64排螺旋CT诊断成人门静脉海绵样变性的影像学表现及价值

目的探讨利用64排螺旋CT动态增强扫描技术及多种血管重建方法诊断门静脉海绵样变性(Cavernous transformation of portal vein,CTPV)的价值和意义。方法 10例经手术、数字血管造影、超声诊断证实的门静脉海绵样变性病例,均行腹部平扫和动态增强扫描及血管后处理成像。结果门静脉海绵样变性主要表现为门脉主干和(或)分支的阻塞,门脉走行区正常结构消失,出现大量向肝性及离肝性侧枝静脉。通过VR、MIP、MPR等血管成像技术能很好的显示门静脉栓塞、侧枝血管的重建与开放情况。结论 64排螺旋CT动态增强扫描及血管成像技术对诊断门静脉海绵样变性及侧枝血管的显示有较大优势和意义。

Imaging Findings and Value of 64-slice Spiral CT in Diagnosis of Cavernous Transformation of Portal Vein

Objective To evaluate 64-slice spiral CT dynamic contrast-enhanced scanning combined with angiography reconstruction techniques in diagnosis of cavernous transformation of portal vein(CTPV).Methods 10 patients with CTPV conformed by surgery,digital angiography and ultrasound underwent plain and dynamic contrast enhanced CT.Multiple angiography reconstruction techniques were used to obtain vascular post-processing images.Results CTPV was primarily characteristic of the portal vein and(or) branch obstruction,loss of normal structure of portal vein region,presence of abundant venous collaterals through and out of liver.Volume rendering view(VR),maximum intensity projection(MIP) and multiplanar reconstruction(MPR) could distinctly display the portal vein embolization as well as reconstruction and opening situation of collateral vessels.Conclusion 64-slice spiral CT dynamic contrast-enhanced scanning combined with angiography reconstruction techniques is capable of making an accurate diagnosis of CTPV and providing more information for clinical therapy decisions.