中文摘要：

目的探讨腹部医学三维可视化系统（MI-3DVS）对门静脉高压症食管胃底静脉曲张（EGV）分布特征与“供血”关系的评估价值。方法收集2010年2月至2012年10月收治的51例门静脉高压症EGV患者上腹部多层螺旋CT（MSCT）薄层数据，采用CT最大密度投影（CT—MIP）法和MI．3DVS对脾胃区侧支循环、EGV进行三维重建，并进行显示率、EGV分型、血供情况的比较。结果MI-3DVS对胃左静脉（LGV）、胃肾分流、脾肾分流、胃后静脉（PGV）的三维显示与CT—MIP相比具有高度-致性（K=0．882～1．000），对胃短静脉（SGV）、食管旁静脉的显示基本-致（K=0．646、0．757）；MI-3DVS对EGV分型结果为I型31例，Ⅱ型6例，Ⅲ型4例，Ⅳ型6例；CT—MIP分型结果为：I型28例，Ⅱ型5例，Ⅲ型4例，Ⅳ型10例，二者存在高度-致性（加权K=0．848，P〈0．01）；各型EGV间血供情况存在明显差异（，=36．647，P〈0．01），EGV分型与血供具有强关联性（C=0．769、0．744，均P=0．000）。12例患者出现胃肾分流，5例出现脾肾分流。结论MI-3DVS能对食管胃底曲张形态、分布与供血关系进行准确评估，对EGV的外科治疗具有重要指导价值。

英文摘要：

Objective To observe the prognostic value of Medical Image Three-dimensional （3D） Visualization System （MI-3DVS） in evaluation of the distribution and blood supply of gastroesophageal varices （EGV）. Methods 3D reconstruction was played by MI-3DVS and CT-maximum intensity projection （CT-MIP）respectively on multi slice computed tomography （MSCT） date of 51 patients with EGV from February 2010 to October ：2012. The demonstration rate of collateral vessels in spleen and stomach area, EGV typing and the blood supply between the two methods were observed and compared. Results The demonstration rates of LGV, gastro-renal shunt, splenorenal shunt and PGV showed a high coincidence between the MI-3DVS and CT-MIP （k = 0. 882-1.000）, and moderate agreements in SGV and paraesophageal varices （ K = 0. 646 and 0. 757）. The outcome of EGV classification （ MI-3DVS vs. CT-MIP） were type I for 31 vs. 28 cases, type H for 6 vs. 4 cases, type Ⅲ for 4 vs. 4 cases and type 1V for 6 vs. 10 cases, the 2 methods show high agreements （ weighted Kappa value of 0. 848 and P 〈 0. 01 ）. Significant differences were found in the blood supply distribution among the four types of EGV （X2 = 36. 647, P 〈 0. 01 ） ; and the blood supply of the EGV tended to be a strong correlation with EGV classification （ C = 0. 769 and 0. 744, P = 0. 000）. There were 12 patients with gastro-renal shunt and 5 patients with Spleno- renal shunt. Conclusions MI-3DVS can explicitly determine the location, blood vessel diameter and blood supply of the EGV, which is helpful for us to grab the formation of collateral circulation completely. The 3D reconstruction of MI-3DVS has guidance and current significance in optimizing therapeutic schedule orpreoperative planning.