MDCTP对肝硬化门脉高压侧支循环血管的显示价值

目的:评价16排螺旋CT门静脉血管成像(MDCTP)技术在显示肝硬化门脉高压侧支循环血管方面的应用价值。方法:对38例临床诊断肝硬化门脉高压的患者行上腹部MDCTP检查。采用MIP、MPR、VR等三维重组技术进行图像后处理,获得门静脉系统及侧支循环血管图像。结果:38例中显示食管胃底粘膜下静脉曲张31例,食管旁静脉曲张10例;胃左静脉曲张29例,胃短静脉曲张26例;脐静脉与腹壁静脉曲张7例;脾-肾或胃-肾分流6例;腹膜后分流2例。结论:MDCTP能显示肝硬化患者门-体侧支循环开放部位、范围及程度,有重要的临床应用价值。

Evaluation of Porto-systemic Collateral Circulation in Liver Cirrhosis Using Multi-Detector Row Spiral CT Portography

Objective:To study the value of multi-detector row spiral CT portography (MDCTP) in assessing the porto-systemic collateral circulation in patients having liver cirrhosis with portal hypertension.Methods:Contrast enhanced abdominal scanning in 38 patients with documented liver cirrhosis and portal hypertension were performed using 16-detector row spiral CT.Various image post-processing techniques such as MPR,MIP,VR were applied to depict the porto-systemic collateral circulation of portal venous system.Results:Varicosis with engorged and tortuous veins were displayed at various locations in this group of cirrhosis patients with portal hypertension,including gastroesophogeal varices (n=31),paraesophogeal varices (n=10),left gastric varices (n=29),short gastric varices (n=26),umbilical and abdominal wall varices (n=7), spleno-renal or gastro-renal shunts (n=6) and the retroperitoneal shunts (n=2) were found. Conclusion:MDCTP technique is a very effective and valuable method for providing important and accurate information of the collateral circulation in cirrhotic patients with portal hypertension.