CAJ | 학술논문

目的探讨先天性脾肾静脉分流的影像学表现及其临床应用价值.方法回顾性分析我院2009年3月至2014年5月127 283例上腹部CT检查资料,共发现6例先天性脾肾静脉分流,分析其影像学资料.患者均行CT平扫及增强扫描和多普勒超声检查.结果先天性脾肾分流的发生率约为47/100万.6例患者均为女性,年龄32～67岁,平均48.8岁.增强MSCT均显示脾与左肾静脉间异常粗大的分流血管影.4例分流血管直径大于脾静脉及门静脉.2例分流血管管径较细;1例同时合并肝内门脉右支缺如.2例合并门脉及脾静脉发育细小.多平面重组(MPR)、曲面重建(CPR)、最大密度投影(MIP)和容积再现(VR)图像可立体显示分流血管走行、开口及入口.多普勒超声检查均显示门脾静脉倒流,血液经分流血管向左肾静脉分流.结论先天性脾肾静脉分流是一种少见的肝外门体分流畸形.MSCT增强扫描结合后处理技术可清晰显示先天性脾肾静脉分流患者的分流血管及其伴发病变.多普勒超声检查可进一步明确血流分流的方向.
목적 탐토선천성비신정맥분류적영상학표현급기림상응용개치.방법 회고성분석아원2009년3월지2014년5월127 283례상복부CT검사자료,공발현6례선천성비신정맥분류,분석기영상학자료.환자균행CT평소급증강소묘화다보륵초성검사.결과 선천성비신분류적발생솔약위47/100만.6례환자균위녀성,년령32～67세,평균48.8세.증강MSCT균현시비여좌신정맥간이상조대적분류혈관영.4례분류혈관직경대우비정맥급문정맥.2례분류혈관관경교세;1례동시합병간내문맥우지결여.2례합병문맥급비정맥발육세소.다평면중조(MPR)、곡면중건(CPR)、최대밀도투영(MIP)화용적재현(VR)도상가입체현시분류혈관주행、개구급입구.다보륵초성검사균현시문비정맥도류,혈액경분류혈관향좌신정맥분류.결론 선천성비신정맥분류시일충소견적간외문체분류기형.MSCT증강소묘결합후처리기술가청석현시선천성비신정맥분류환자적분류혈관급기반발병변.다보륵초성검사가진일보명학혈류분류적방향.
Objective To study the imaging appearances of congenital splenorenal venous shunt,and to evaluate their clinical significances.Methods Of 127 283 patients who underwent upper abdominal CT scanning,6 patients were diagnosed to have congenital splenorenal venous shunt.The imagings were studied retrospectively.Plain scanning,enhanced CT and Doppler ultrasonography were performed on all these patients.Results The incidence was about 47/million.The six patients were all females,the age was between 32 to 67 years.The mean age was 48.8 years.Enhanced CT demonstrated that there were twisted and dilated shunting blood vessels between the splenic and renal veins.The diameters in four patients were larger than the splenic and portal veins.In the remaining two patients,they were smaller shunting blood vessels.One patient had an associated absence of right portal vein.Two patients had associated dysplasia of portal veins and splenic veins.MPR,CPR,MIP and VR could three-dimensionally depict the courses,the beginnings and the ends of the splenorenal shunts.Doppler ultrasonography showed counterflow between the portal and splenic veins,and showed the blood in the splenic vein to flow into the left renal vein.Conclusions A congenital splenorenal venous shunt is one of the rare form of congenital extrahepatic portosystemic venous shunts.Enhanced MSCT scan combining with its post-processing techniques could clearly demonstrate the shunt vessels and the associated lesions.Doppler ultrasonography could further demonstrate the shunt direction.