【摘要】 目的:探讨门静脉栓塞的MSCT诊断价值。方法:回顾性分析29例经临床/手术病理证实的门静脉栓塞患者的MSCT表现和临床资料,29例中门静脉血栓(PVT)13例(PVT组),门静脉瘤栓(PTT)16例(PTT组)。结果:29例栓子的部位、范围均清晰显示;13例PVT中9例继发于肝硬化门静脉高压;CT平扫呈等或稍高密度,动态增强呈不同形态、无强化的低密度充盈缺损;7例呈典型的"靶征",5例呈"线样征"。16例PTT均继发于肝癌;CT平扫表现为等或稍低密度,动态增强呈形态各异、不均匀强化的充盈缺损;PVT组与PTT组间CT强化差异具有统计学意义(P=0.000);PVT组完全阻塞3例(3/13),PTT组12例(12/16),PTT组完全阻塞率高于PVT组(P=0.040);PVT组管腔局部扩张2例(2/13),PTT组12例(12/16),PTT组管腔局部扩张高于PVT组(P=0.030);PVT组管壁局部不光整1例(1/13),PTT组14例(14/16),PTT组管壁局部不光整率高于PVT组(P=0.000)。结论:MSCT能显示门静脉栓塞的影像特征,准确判断栓子的部位、范围及性质,对该病的诊断具有重要价值。更多还原

【Abstract】 Objective:To investigate the multi-detector row spiral CT(MSCT)features of the portal vein embolism and assess its diagnostic value in this disease.Methods:The MSCT and clinical data were reviewed and analyzed in 29 patients with portal vein embolism confirmed by clinical study and pathology,consisting of 13 cases in the thrombosis group and 16 cases in the tumor embolus group.Results:The location and size of emboli in 29 cases were clearly displayed.In the13 cases of thrombosis,9cases were secondary to liver cirrhosis portal hypertension,isodensity or slightly high density was shown on plain scan,and low density filling defect with different forms without enhancement was shown on dynamic enhancement scan.7cases showed typical "target sign" and 5cases showed "line sign".All 16 cases of tumor embolus were secondary to liver cancer,isodensity or slightly low density was shown on plain scan,uneven enhanced filling defect with different forms on dynamic enhanced scan.The difference was statistically significant in the degree of enhancement between the two groups.There was complete obstruction in 3cases of thrombosis,incomplete obstruction in 10cases;and complete obstruction in 12 cases of tumor embolus,incomplete obstruction in 4cases.The rate of complete obstruction in the portal vein tumor embolus was higher than that in the portal vein thrombosis,the difference was statistically significant.The vascular lumen adjacent to the thrombus was expanded in 2cases,while that adjacent to the tumor embolus was expanded in 12 cases.There was local unevenness of vascular wall in one cases of thrombosis group,while that was in 14 cases of the tumor embolus group,the difference was statistically significant.Conclusion:MSCT can show the image features of the portal venous emboli,and can judge the location,extent and nature of the emboli accurately,it’s of important value in the diagnosis of the disease.更多还原