目的探讨多层螺旋CT(MSCT)门静脉成像对肝硬化门脉高压侧支循环的诊断价值。方法对109例经临床、肝功能和影像学检查诊断为肝硬化门脉高压患者行腹部三期增强扫描,经图像后处理,获得门静脉系统及侧支血管三维重建图像。结果 CTPV可以直观地显示门静脉系统及侧支循环。109例中,胃左静脉曲张67例(61.5%),食管下段静脉曲张87例(80.0%),胃后/短静脉曲张10例(9.2%),食管旁静脉曲张21例(19.3%),胃/脾-肾静脉分流14例(12.8%),门静脉海绵样变18例(16.5%),附脐静脉、腹壁静脉曲张15例(13.8%),椎旁静脉分流6例(5.5%)。结论 MSCT门静脉成像可精确显示各类侧支循环的部位、程度及走行,可为临床治疗前评估提供可靠的影像依据。
Objective To evaluate the diagnostic value of multiple slice spiral CT portal venography ( CTPV) in the collateral circulation of liver cirrhosis with portal hypertension .Methods Tri-phase enhanced CT scan was performed in 109 patients with portal hypertension dut to cirrhosis .The diagnosis was proved by clinical data ,hepatic function findings and imaging signs .Three dimension imaging reconstruction of portal venous system and portal collat -eral circulation were obtained using posl-processing reconslruction technique .Results CTPV images displayed the portal venous system and its collateral circulation stereoscopically .Of 109 patients, left gastric varices were seen in 67(61.5%), lower esophageal varices in 87(80.0%), short gastric or posterior gastric varices in 10 (9.2%), par-aesophageal varices in 21(19.3%), gastro-renal or splenorenal shunts in 14(12.8%), spongelike transformation of portal vein in 18(16.5%), paraumbilical and abdominal wall varices in 15(13.8%), paravertebral venous shunts in 6(5.5%).Conclusion Multiple slice spiral CT can precisely display the location , extent and course of the col-lateral circulation .It can provide reliable imaging evidence for clinical evalution before treatment .