36例门静脉3D DCE MRA与常规门静脉造影的对照

目的与常规门静脉造影对照，评价门静脉三维动态增强磁共振血管成像(3DDCEMRA)的使用价值。方法36例病人做了门静脉3DDCEMRA成像，分析门静脉3DDCEMRA上门脉主干、肝内门脉左右分支的开放性，侧支循环发生的部位和严重程度。显示结果与门静脉造影术相对照，评价两者的符合情况。结果在36例病人108支门脉主干和分支中，有104支两种检查方法显示门脉的开放性的结果相同，符合率为96％。3DDCEMRA发现20处冠状静脉曲张，4处自发性脾肾分流和3处脐静脉重开，漏诊1处脐静脉重开。3DDCEMRA所揭示的侧支循环的分布情况同门静脉造影术的符合率为96％。结论门静脉3DDCEMRA同常规门静脉造影术符合率高，它能较准确地显示门脉的开放性和侧支循环的分布情况，在多数病例中能够取代创伤性门脉造影术。

3D DCE MRA in the Imaging of the Portal Vein:A Correlative Study with Conventional Portography in 36 Cases

Purpose To evaluate the usefulness of 3 dimensional dynamic contrast enhanced magnetic resonance angiography (3D DCE MRA) in the imaging of the portal vein. Methods 36 patients underwent 3D DCE MRA of the portal vein.The patency of the main portal vein,its right and left intrahepatic branches was examined. The distribution and extent of collaterals were also assessed.The findings of 3D DCE MRA were compared with those from conventional portography(percutaneous transhepatic portography or transsplenic vein portography or transarterial indirect portography or transjugular intrahepatic portography). Results Of the 108 portal veins from 36 patients evaluated with both techniques,appearances were identical in 104,percentage of agreement in the demonstration of the patency of the portal vein was 96%. But findings of the patency were discordant in four intrahepatic portal veins. The presence of collaterals revealed by 3D DCE MRA was correlated well with portography,percentage of agreement between the two methods reaching 96%. Conclusions 3D DCE MRA facilitated quite accurate determination of the portal venous patency and existence of varices,images correlating well with conventional portography. It can replace invasive portography in most cases.