门脉高压心膈角静脉曲张MSCT研究

目的探讨门脉高压症患者心膈角静脉曲张的发生率、MSCT表现及临床意义。方法回顾性分析140例门脉高压症患者的MSCT图像,利用MPR、MIP及VRT技术对心膈角区结节状或(和)管状影进行分析并测量。结果140例门脉高压症患者中有44例(31.4%)心膈角静脉曲张,以右前心膈角为多见;MSCT表现为心膈角区结节样和(或)管状软组织密度影,边界清楚,体积较小,曲张静脉直径为3.5~14.0mm,平均6.7mm;三期动态增强扫描曲张静脉从动脉期到静脉期逐渐增强,CT值与同层静脉血管(如食管胃底曲张静脉)大致相同;MPR、MIP及VRT技术可显示大多数(73%)心膈角区结节状或(和)管状影与心包膈静脉、膈肌静脉密切相关。结论心膈角静脉曲张在门脉高压症患者中并不少见,MSCT可以对其进行良好的显示,对心膈角静脉曲张的诊断及鉴别诊断具有重要的临床意义。

The Evaluation of Cardiophrenic Angle Varices in Portal Hypertension with MSCT

Objective To study the incidence,CT appearances and the clinical significance of cardiophrenic angle (CPA) varices in patients with portal hypertension (PHT).Methods MSCT images in 140 cases of PHT were retrospectively analysed.The paracardiac region was assessed for nodulous and tubular masses suggested varices with the techniques of MPR,MIP and VRT,the variceal diameter was also noted.Results Nodulous and tubular masses consistent with CPA varices were noted in 44 cases(31.4%)and were more common at the right side than the left.The diameter of masses with clear boundary was from 3.5 to 14.0 mm with average 6.7 mm;tri-period contrast-enhancement showed the masses enhanced gradually from arterial phase to venous phase , the CT value was approximate to the venous blood in same slice (such as oesophageal gastric varices);with the techniques of MPR,MIP and VRT and so on,of 73% nodosity or (and) tubiform masses were displaied to connect with pericardiacophrenic veins and diaphragmatic muscle veins.Conclusion Cardiophrenic angle varice is not uncommon in PHT and can be showed well by MSCT, MSCT has considerable clinical significance in the diagnosis and differential diagnosis.