腹部增强CT扫描动脉期的下腔静脉和肝静脉返流显影的临床意义

目的探讨腹部增强CT扫描动脉期出现下腔静脉和肝静脉返流显影的临床意义。资料与方法对2008年5月至2011年3月间的18例腹部增强CT扫描动脉期出现下腔静脉和肝静脉显影患者的影像资料进行回顾性分析,同时随机选取20例无下腔静脉和肝静脉返流显影的受检者为对照,并将2组CT影像资料与超声心动图进行比较。结果 18例腹部增强CT扫描动脉期下腔静脉出现返流患者中14例合并肝静脉的返流,强化的下腔静脉和肝静脉与右心房和上腔静脉密度近似,高于胸主动脉密度,近端比远端密度高。18例患者的超声心动图显示三尖瓣返流17例,其中15例合并其他瓣膜异常,包括二尖瓣返流8例,主动脉瓣返流5例,肺动脉瓣返流4例。其他CT表现包括增强后斑片状强化的肝脏充血4例,心包积液3例。对照组20例受检者超声心动图提示三尖瓣少量返流3例,二尖瓣少量返流2例。两组肝上段下腔静脉前后径测量平均值分别为25.4 mm和19.2 mm,两组差异有统计学意义。结论增强CT扫描动脉期出现下腔静脉和肝静脉返流显影可提示心脏疾病的可能。

Clinical Relevance of Retrograde Hepatic Vein and Inferior Vena Cava Opacification on Enhanced CT

Objective To explore the clinical relevance of retrograde hepatic vein and inferior vena cava(IVC) opacification on enhanced CT.Materials and Methods 18 patients with retrograde opacification of hepatic vein and(or) IVC received abdominal enhanced CT of and 20 healthy subjects were included in this study.Two group’s subjects were performed with echocardiography.Results Among 18 patients,early reflux opacification of the IVC and hepatic veins were demonstrated in 14 cases,which density was higher than that in the aorta,17 cases were found to have tricuspid regurgitation confirmed by echocardiography.15 cases were complicated with other valve disorder in 17 cases,including mitral regurgitation in 8 cases,aortic regurgitation in 5 cases,and pulmonary valve regurgitation in 4 cases.Additional CT findings included patchy parenchymal liver enhancement in 4 cases and pericardial effusion in 3 cases.The anteroposterior diameter of the suprahepatic IVC of the 18 patients was significantly greater than those of 20 subjects in control(t = 4.661,P< 0.01).Conclusion Retrograde opacification of the hepatic vein or IVC during enhanced CT indicate cardiovascular diseases possible.