64层螺旋CT门静脉三维重组对门静脉高压侧支循环的研究及临床应用

目的：评价64层螺旋CT门静脉三维重组对门静脉高压侧支循环的诊断价值及临床应用。方法：正常者20例,肝硬化患者39例,行64层螺旋CT门静脉造影,容积数据采用最大密度投影（MIP）、容积再现法（VR）、表面遮盖法（SSD）、多平面重组（MPR）三维重组,观察门静脉高压肝内门静脉、属支及侧支循环的影像学特征。结果：64层螺旋CT门静脉三维重组能准确显示侧支循环分布范围、初步评估病变程度,门静脉高压症组门静脉属支管径显著大于正常组（P=0.000）,64层螺旋CT诊断食管胃底静脉曲张与胃镜诊断有高度一致性。结论：64层螺旋CT门静脉三维重组能够多角度、立体观察侧支循环情况,对预测其并发症、手术方案的制定具有重要的指导意义。

Portography diagnostic value of collateral circulation of portal hypertension on 64-slice spiral CT

Objective：To evaluate the portography diagnostic value in portosystemic collateral shunts of portal hypertension with 64-slice spiral CT. Methods：Thirty normal subjects and 39 liver cirrhosis patients were performend by MSCTP. MIP,VR and MPR were employed for three dimensional reconstruction. The images of portal venous grades and collateral shunts were estimated and compared. Results：Collateral circulation in live cirrhosis cases were displayed well,and the extent was accessed preliminarily. The portal system diameter of liver cirrhosis group was larger than normal groups significantly （main portal vein,splenic vein,superior mesenteric vein; P=0.000）. There was hight consistence between 64-slice spiral CT and the gastroscope in the diagnosis of esophageal and gastric varices were diagnosed. Conclusion：The portalgraphy of 64-slice CT can display portal venous system and compensatory circulation distinctly and stereoscopically. The portography of 64-slice CT can predicate the complication and the decision of approaches for the surgical treatment.