CAJ | 학술논문

目的：采用多排螺旋CT增强扫描及三维重建技术评价急慢性门静脉系统血栓（PVT）。方法回顾性分析已证实的住院患者PVT的增强螺旋CT表现。根据症状发作时间将PVT分为急性期、慢性期，根据形态将血栓分为Ⅰ型完全型和Ⅱ型偏心型，分别评价门静脉直径、血栓位置、形态、密度、强化及伴随征象。结果 PVT形成患者19例。急性期3例，均为完全型；2例同时累及门静脉主干、左右分支、肠系膜上静脉及脾静脉，1例累及除门静脉主干外的其他3支血管。血栓CT值平均为（39±19）Hu，2例在血栓内部或边缘可见轻度强化。均有肠壁增厚、肠腔扩张积液、肠系膜水肿、腹水及侧支循环形成。慢性期16例，3例累及4支血管，4例累及3支，7例累及2支，2例累及1支。5例为完全型，11例为偏心型（68．8％），其中8例（72．7％）血栓宽径小于门脉宽径的50％。血栓 CT值平均为（41±12）Hu，3例强化。腹水15例，肠系膜水肿10例，侧支循环形成14例。结论 MSCT增强扫描可对急慢性PVT的累及范围及形态特点做出准确评价。
목적：채용다배라선CT증강소묘급삼유중건기술평개급만성문정맥계통혈전（PVT）。방법회고성분석이증실적주원환자PVT적증강라선CT표현。근거증상발작시간장PVT분위급성기、만성기，근거형태장혈전분위Ⅰ형완전형화Ⅱ형편심형，분별평개문정맥직경、혈전위치、형태、밀도、강화급반수정상。결과 PVT형성환자19례。급성기3례，균위완전형；2례동시루급문정맥주간、좌우분지、장계막상정맥급비정맥，1례루급제문정맥주간외적기타3지혈관。혈전CT치평균위（39±19）Hu，2례재혈전내부혹변연가견경도강화。균유장벽증후、장강확장적액、장계막수종、복수급측지순배형성。만성기16례，3례루급4지혈관，4례루급3지，7례루급2지，2례루급1지。5례위완전형，11례위편심형（68．8％），기중8례（72．7％）혈전관경소우문맥관경적50％。혈전 CT치평균위（41±12）Hu，3례강화。복수15례，장계막수종10례，측지순배형성14례。결론 MSCT증강소묘가대급만성PVT적루급범위급형태특점주출준학평개。
Objective To evaluate acute or chronic portal vein system thrombosis(PVT)using multiple slice spiral computer tomography(MSCT).Enhancement MSCT and three-dimensional CT reconstruction technique were applied in all patients.Methods Findings from inpatients proved portal vein system thrombosis were retrospectively reviewed.The portal venous system thrombosis was divided into acute or chronic stages according to the time from the onset of symptoms.The form of the blood clots fell into Ⅰ complete type and Ⅱ eccentric type.The diameter of the portal vein(DPV)was measured,and the location,shape,density,enhancement of the thrombi and the accompanying signs were assessed.Results Nineteen inpatients with portal vein system thrombosis were enrolled.Three cases were acute PVT and all were type Ⅰ.There were two cases involving portal vein,at the same time around the trunk, branches,superior mesenteric vein and splenic vein.One case was involved the other three veins in addition to the main trunk of portal vein.The average CT value of the acute thrombi was (39±19)Hu.Two cases could be seen the light enhancement at the edge or within the thrombi.Bowel wall thickening,lumen effusion and expanding,mesenteric edema,ascites,and collateral circulation could be seen in all cases.Sixteen patients were chronic PVT.There were two cases involving four blood vessels aforementioned,four cases involving three blood vessels,seven cases involving two blood vessels,and two cases involving one blood vessel.Five cases were type Ⅰ and eleven cases were type Ⅱ.In the type Ⅱ,the width of the clots was less than 50% of DPV in eight cases.The average CT value was (41 ± 12)Hu. Three cases could be seen light enhancement of the blood clots.Ascites (n =15),mesenteric edema (n =10), collateral circulation (n=14)could be observed.Conclusion The scope and form characteristics of acute or chronic PVT could be evaluated accurately by enhancement MSCT.