肝硬化门脉高压腹膜后静脉曲张CT表现

目的：分析肝硬化门脉高压腹膜后静脉曲张CT表现，探讨其临床应用价值。方法：搜集门脉高压腹膜后静脉曲张患者24例，其中14例行3mm薄层容积扫描，最大强度投影法重建。结果：腹膜后Retzius静脉丛9例，CT增强示胰腺、十二指肠及升、降结肠周围蚯蚓或粗管状增强血管影；脾肾侧支开放14例，表现为脾门及左肾静脉之间柱状或转告愉状强化影，其中5例曲张静脉向肾后区域延伸；椎旁静脉曲张6例，表现为腰静脉、腰升静脉扩大增粗，并与椎管内静脉丛相通。结论：CT增强扫描对腹膜后静脉曲张诊断有鉴别诊断具有重要价值，MIP血管成像立体显示脾肾侧支开放有椎旁静脉曲张，对于肝性脑病预测具有一定临床意义。

CT characteristics of retroperitoneal varices in liver cirrhosis with po rtal hypertension

Objective:To investigate CT characteristics of retroperitoneal varices(RV) in liver cirrhosis(LC) with portal hypertension.Methods:24 patients of portal hypertension with RV were included in this study,14 of them underwent CT angiography with MIP(Maximum Intensity Projection) at 3mm thin slice volume scanning and 1.5mm reconstruction interval.Results:9 cases of Retzius varices presented as lumbricoid or tubular enhanced veins around pancreas,duodenum,ascending and descending colon. 14 cases of splenorenal shunt showed columnar and massive uniformly enhanced veins between splenic and left renal vein,5 cases of them extended to retrorenal region.6 cases of paravertebral varices demonstrated dilated lumbar veins and lumbar ascending veins connecting with intravertebral venous plexus.Conclusion:Enhanced CT scanning is very important in demonstrating RV and in its differential diagnosis.CT angiography with MIP can well demonstrate splenorenal shunt and paravertebral varices,it is also important in assessing hepatic encephalopathy.