【摘要】 目的 探讨磁共振血管造影(MRA)对门静脉高压症(PHT)的门静脉系统解剖成像和血流动力学研究的价值.方法 实验组为15例PHT症,对照组为10例正常人;MRA参数:采用Siemensl.5T磁共振仪,体相位线圈,造影剂Gd-DTPA 0.2mmol/kg肘静脉注射,3D-FISP序列扫描门静脉系统,MIP法重建血管;PC法测定门静脉血流动力学指标.结果(1)PHT门静脉主干(MPV)、脾静脉(SPV)、肠系膜上静脉(SMV)直径(cm)分别为1.58±1.17,1.28±0.19,1.10±0.19,均明显高于对照组(1.13±0.10,0.90±0.10,0.80±0.10).(2)ChildA、B级病人间MPV直径无差别(P>0.05).(3)PHT病人的曲张静脉、侧支循环显示阳性率高,显影清晰.(4)PHT组对照组MPV的四流速度分别为8.34±1.06和7.52±1.79cm/s,血流量分别为8.90±1.46和10.47±2.71cm/s.结论 MRA对于PHT的门静脉及曲张静脉、侧支循环显影清晰,并可进行无创性的血流动力学研究,明显优于Doppler和其它常规影像检查,对于门静脉高压、TIPSS、肝移植、肝癌等手术的手术方式选择、手术效果评价及预后的评估可能有重要的指导意义.更多还原

【Abstract】 Objective : To investigate the value of MRA in imaging the portal venous system in portal hypertensive patients. Methods: Experimental group: 15 portal hypertensive patients (PHT), Control: 10. MRA protocol: Gd-DTPA 0. 2mmol/kg as contrast, 3D-FISP sequence was used to imaging portal venous system, with MIP to reconstruct vessels; PC sequence was applied to measure the portal hemodynamic parameters. Results:(1)Diameters of main portal vein (MPV 1. 58 ± 0. 17cm), splenic vein (SPV1. 28 ±0.19cm), superior mesentery vein (SMV 1.10 ± 0.19cm) and MPV/AO (0. 95 ± 0. 20cm) were larger in PHT than those of control respectively(1.10 ±0.10,0.90 ±0.10,0.80 ±0.10,0.66 ±0.10. (2)The differences of MPV,MPV/AO between Child A and B classes were not sig- nificantly different. (3) Positive imaging rates of variceal veins in PHT were high in PHT patients by MRA. (4) The differences of mean velocity and quantity of portal flow between PHT and control are not significant. Conclusion:MRA is superior to Dopple and other routine imaging procedures in imaging portal venous system of portal hypertensive patients and is significant in directing portal hypertension operation, liver transplantation and other operations.更多还原