多层螺旋CT在门脉高压外科治疗中的临床价值

目的:探讨术前多层螺旋CT扫描在门脉高压外科治疗中的价值。方法:随机选取80例门脉高压患者,分别进行术前常规多层螺旋CT扫描及内镜检查;术前常规多层螺旋CT扫描主要对扩张食道及胃底静脉进行重建,并按照静脉扩张的程度、部位以及胃静脉曲张的不同将其分类,并与内镜检查结果相对照。结果:80例门脉高压患者,多层螺旋CT扫描均能显示扩张的食管下段静脉,其中CTPV1型22例,2型25例,3型13例,420例;胃静脉曲张以胃左静脉为主(GEV1型)的36例,以胃冠状、胃短静脉为主(GEV2型)的34例,以胃冠状、胃短静脉供血(IGV型)的10例。内镜检查结果提示食管下段静脉扩张71例,胃静脉曲张GEV1型37例,GEV2型32例,IGV型11例。多层螺旋CT在显示食道扩张的静脉方面优于内镜组(P<0.05);多层螺旋CT在引流静脉分布的显示方面与内镜组基本一致(P>0.05)。结论:术前多层螺旋CT能准确的判定门脉高压食管、胃底扩张静脉的程度及分布,能有效指导外科手术治疗,具有很高的临床价值。

Clinical value of multislice computed tomography slice in surgery of portal hypertension

Objective: To explore the value of multislice computed tomography(MSCTA) in portal hypertension surgery.Methods:Eighty cases of portal hypertension were enrolled,preoperative MSCTA and endoscopic examination were respectively preformed;varices of fundus of stomach and esophagus were rebuilt and divided into different categories according to the severity and location.Results were compared with status revealed by endoscope.Results: MSCTA could display all the esophageal varix lesions in the 80 cases,of which 21 were CTPVⅠ,25 were CTPVⅡ,13 were CTPVⅢ,and 20 were CTPVⅣ.Gastric varices mainly characterized as GEV1(36 cases),GEV2(34 cases),IGV(10 cases).Endoscope revealed 71 cases of esophageal varix lesions,37 cases of GEV1,32 cases of GEV2,11 cases of IGV indicating it’s superior to MSCTA regarding to detection of the esophageal varix lessions(P<0.05);while no significant difference was found in revealing varices of fundus of stomach between the two methods(P>0.05).Conclusions:Preoperative MSCTA is able to detect and reveal distribution of varix,thus can effectively guide the surgical procedure.