多层螺旋CT在诊断食道静脉曲张中的价值

目的:探讨64排螺旋CT门静脉成像(computed tomography portal venography,CTPV)在诊断食道静脉曲张(esophageal varices,EV)中的价值。方法:收集我院2005年1月~2010年3月经胃镜证实的80例肝硬化EV的CTPV表现,观察EV的部位、范围、程度、供血血管的类型、胃肾静脉、脾肾静脉的分流情况,并与胃镜进行对比,分析食道静脉曲张的侧枝循环供血特点。结果:80例肝硬化EV患者中,出血组40例,Ⅰ、Ⅱ型39例,重度36例;非出血组40例,Ⅰ~Ⅱ型28例,重度5例;80例EV患者在CTPV中显示率为100.0%;肝硬化组与正常对照组、出血组与非出血组胃左静脉直径差异有统计学意义(P<0.05)。结论:EV在CTPV上的范围、程度与胃镜有很好的相关性;其EV的部位分型与其侧支循环的血供特点关系密切。多层螺旋CT能较全面、较准确地显示肝硬化食道胃静脉曲张的侧枝循环建立情况,为临床诊断和治疗提供较丰富的影像学依据。

Value of MDCT in diagnosing esophageal varices

Objective：To evaluate the value of 64-detector row spiral computed tomography portal venography（CTPV） in diagnosing esophageal varices（EV）.Methods：A total of 80 patients with CTPV images,who suffered from hepatic cirrhosis esophageal varices confirmed by endoscopy,and 80 normal cases from January 2005 to March 2010 were collected.The location,scope,extent,type of blood vessels,shunt condition of stomach-renal vein and /or spleen-renal vein were observed and compared with endoscopy.The character of blood supply from collateral circulation of the esophageal varices was analyzed.Results：There were 40 cases with bleeding,including 39 cases in typeⅠandⅡ,respectively and 36 severe cases;and 40 cases without bleeding including 28 cases in typeⅠorⅡand 5 severe cases.The accuracy of CTPV was 100.0%.And there were significant differences in diameter of left stomach vein between cirrhosis group normal group and bleeding group non-bleeding group（P0.05）.Conclusions：CTPV imaging of EV shows well relativity to gastroscopy in scope and degree.The type is close associated with character of blood supply from lateral circulation.CTPV can comprehensively and accurately display lateral circulation of EV in cirrhosis patients,and can provide imaging evidence for diagnosis and treatment.