门脉高压脐静脉再通及其螺旋CT血管成像

目的 :探讨螺旋CT血管成像 (SCTA)技术对脐静脉开放的诊断价值以及脐静脉与腹壁静脉侧支、附脐静脉的关系。材料和方法 :对 2 7例门脉高压脐静脉再通患者行全肝扫描 ,采用最大强度投影 (MIP法 )重建。结果 :脐静脉呈细管状开通 18例 ,粗管状 9例 ,SCT断面像表现为连续点状、结节或条管状增强血管影 ,SCTA显示肝圆韧带裂内一粗或细管状扭曲增强血管 ,向前与脐周曲张静脉相通 ;腹壁静脉曲张 2 1例 ,SCT断面像表现为腹壁小点状或小条形血管影 ,曲张静脉越近脐部越明显 ,SCTA示“海蛇头样”(Caputmedusae)改变。结论 :门脉高压时与门脉左支相连的侧支静脉为脐静脉 ,SCTA可多方位、多角度立体显示其解剖学特点。

Spiral CT Angiography of Patent Umbilical Vein in Portal Hypertension

Purpose: To investigate the diagnostic value of Spiral CT Angiography of patent umbilical vein, the connection of umbilical vein with paraumbilical vein and collateral veins of the anterior abdominal wall. Materials and Methods: 27 cases of patent umbilical vein with portal hypertension were included in the study and underwent whole liver SCT, Maximum Intensity Projection was employed for image post-processing. Results: The umbilical vein reopened with tenuous or coarse pipeline, their number were 18 or 9 separately. The axial images from spiral CT demonstrated continuous dotted, nodular or tubular enhanced vessels, SCT with MIP angiography demonstrated dilated and tortuous enhanced vein in the falciform ligament. There were 21 cases of varices in the anterior abdomen wall, SCT depicted small dotted or tubular enhanced vessels, the variceal vessels were more apparent approaching to the umbilicus, SCTA demonstrated the enlarged umbilical vein running anteriorly and medially to join a plexus of dilated superficial epi-gastric veins (caput medusa). Conclusion: The collateral veins connected to the left portal vein are umbilical vein, SCTA with multiplanar and multidimensional MIP reformations can well reveal the anatomical feature of the umbilical vein.