【摘要】 目的:探讨经皮脾门静脉99mTc-Phytate显像对肝硬化门静脉高压及其侧支循环的诊断价值和临床意义。方法:对50例肝硬化门静脉高压患者和10例阴性对照者采用经皮脾门静脉99mTc-Phytate显像、彩色多普勒超声和胃镜检查。根据肝功能Child-Pugh分级将肝硬化门静脉高压患者分为A级15例,B级19例,C级16例。结果:经皮脾门静脉99mTc-Phytate显像显示对照组脾门静脉呈"S"形,门体分流指数(PSSI)为0.19±0.07;肝硬化门静脉高压患者分为3型:肝内分流型13例,PSSI为0.52±0.19,侧支循环型31例,PSSI为0.64±0.28,完全肝外型6例,PSSI为0.91±0.03。按其血管走向门静脉侧支循环又分为上行为主、下行为主及混合型。PSSI随肝硬化ChildA、B、C分级依次升高(P<0.05)。结论:经皮脾门静脉99mTc-Phytate显像能对肝硬化门静脉高压作出较为准确的定量和侧支循环的形态学诊断,为治疗提供依据。更多还原

【Abstract】 Objective: To investigate the diagnostic value and clinical significance of trans-splenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation. Methods: Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 cases were Child B, and 16 cases were Child C. Results: In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19±0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52±0.19), compensatory(31 patients; index, 0.64±0.28)and completely extrahepatic (6 patients; index, 0.91±0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups(P<0.05). Conclusion: Transsplenic portal scintigraphy is sensitive for detecting the number and location of shunts and will allow for improved surgical planning.更多还原