【摘要】 目的 分析门脉海绵状变性(CTPV)的CT表现和病因,探讨CT诊断的临床价值。方法 12例CTPV患者均经全腹部CT平扫及螺旋三期增强扫描,图像后处理技术包括MIP和MPR;图像分析由2名5年以上工作经验的放射科医师独立完成。经临床证实病因包括先天发育异常2例,胆囊炎合并腹腔脓肿1例,肝硬化4例,胰腺癌2例,肝海绵状血管瘤、胆囊癌和直肠癌肝转移各1例。结果 (1)门脉主干及分支异常:肝门部门脉走形区存在多发呈结节状或蚯蚓状的细小静脉血管影9例,门脉充盈缺损2例,狭窄2例,显示不清或闭塞4例;(2)侧支循环静脉开通:脾门区静脉曲张8例,肠系膜静脉曲张7例,食管胃底静脉曲张5例,胃肾静脉曲张5例,直肠静脉曲张2例;(3)其他征象包括:肝动脉增粗7例,肝脏灌注异常3例,胆道扩张2例,腹水2例,脾大2例。结论 CT在确定本病的诊断同时能明确原发病因的性质、危害程度和累及范围,有助于临床制定合理的个性化治疗方案。更多还原

【Abstract】 Objective To analyze the CT findings and etiology of cavernous transformation of portal vein(CTPV),and to evaluate the clinical value of CT diagnosis.Methods 12 patients with CTPV underwent plain abdomen CT scan and spiral three-phase enhanced scan.The image post-processing techniques included MIP and MPR.All images were analyzed independently by two radiologists who had more than 5 years working experience.The etiology were congenital dysplas ia in 2 cases,cholecystitis with abdominal abscess in 1case,cirrhosis in 4 cases,pancreatic cancer in 2 cases,hepatic cavernous hemangioma,gallbladder cancer and hepatic metastasis of rectal cancer in 1 case,respectively.Results(1) Portal vein and its branch abnormalities:there were fine dilated portoportal collaterals around the portal vein in hepatic hilum in 9 cases,portal vein filling defect in 2 cases,stenosis in 2 cases,unclear or occlusion in 4 cases.(2)Dilated collateral vessels were found around splenic hilum in 8 cases,mesentery varices in 7 cases,esophageal and gastric varices in 5cases,gastro-renal varices in 5 cases and rectal varices in 2 cases,respectively.(3) Other findings including hepatic artery thickening in 7 cases,abnormal liver perfusion in 3 cases,biliary dilatation in 2 cases,ascites in 2 cases and splenomegaly in 2 cases.Conclusion CT is able to determine the diagnosis of the disease as well as identify their etiology,damage degree and the involvement range,so as to help clinician to make reasonable management for each patent.更多还原