泰山医学院学报
泰山醫學院學報
태산의학원학보
Journal of Taishan Medical College
2015年
11期
1244-1246
,共3页
肝硬化%多层螺旋 CT%门静脉高压症%成像%侧枝循环
肝硬化%多層螺鏇 CT%門靜脈高壓癥%成像%側枝循環
간경화%다층라선 CT%문정맥고압증%성상%측지순배
liver cirrhosis%multislice computed tomography%portal hypertenshion%portal venous angiography%collat-eral circulation
目的：探讨肝硬化门静脉高压患者侧枝循环建立的影像学特点。方法随机选取我院从2014年1月至2015年5月，经临床、实验室检查、超声、内镜等检查诊断有肝硬化门静脉高压病人105例，行上腹部 CT 增强扫描。其中男85例，女20例。乙肝肝硬化99例，酒精性肝硬化3例，淤血性肝硬化2例，药物性肝硬化1例。另选非肝硬化病人作为对照组，共75例，男50例，女25例。使用 GE 公司双源 CT。对比剂使用碘海醇（350 mgl/ ml）高压注射。增强扫描时对比剂量按1.4ml/ kg 静脉注射，注射速度设定为4.5ml/ s。动脉期扫描时间为腹主动脉强化峰值时间延迟2s，门静脉期的扫描时间以测得小剂量预注射峰值时间相应延迟3s、5s、7s、9s。图像中采用 MPR、MIP、VR 三维重建及曲面重建。轴位像及重建图像结合分析门静脉侧枝循环的解剖路径。结果105例被检者门静脉侧枝开放通路中常见通路有：胃底及胃小弯侧静脉曲张74.29%，食管静脉曲张48.57%，附脐静脉开放占25.71%。结论 MPR、MIP、VR 重建方法能够很好地显示门静脉侧枝循环通路的解剖特点，其中以胃底、胃体部曲张静脉最为多见，是门静脉高压侧枝循环开放情况的定位、定性诊断的有效工具。
目的：探討肝硬化門靜脈高壓患者側枝循環建立的影像學特點。方法隨機選取我院從2014年1月至2015年5月，經臨床、實驗室檢查、超聲、內鏡等檢查診斷有肝硬化門靜脈高壓病人105例，行上腹部 CT 增彊掃描。其中男85例，女20例。乙肝肝硬化99例，酒精性肝硬化3例，淤血性肝硬化2例，藥物性肝硬化1例。另選非肝硬化病人作為對照組，共75例，男50例，女25例。使用 GE 公司雙源 CT。對比劑使用碘海醇（350 mgl/ ml）高壓註射。增彊掃描時對比劑量按1.4ml/ kg 靜脈註射，註射速度設定為4.5ml/ s。動脈期掃描時間為腹主動脈彊化峰值時間延遲2s，門靜脈期的掃描時間以測得小劑量預註射峰值時間相應延遲3s、5s、7s、9s。圖像中採用 MPR、MIP、VR 三維重建及麯麵重建。軸位像及重建圖像結閤分析門靜脈側枝循環的解剖路徑。結果105例被檢者門靜脈側枝開放通路中常見通路有：胃底及胃小彎側靜脈麯張74.29%，食管靜脈麯張48.57%，附臍靜脈開放佔25.71%。結論 MPR、MIP、VR 重建方法能夠很好地顯示門靜脈側枝循環通路的解剖特點，其中以胃底、胃體部麯張靜脈最為多見，是門靜脈高壓側枝循環開放情況的定位、定性診斷的有效工具。
목적：탐토간경화문정맥고압환자측지순배건립적영상학특점。방법수궤선취아원종2014년1월지2015년5월，경림상、실험실검사、초성、내경등검사진단유간경화문정맥고압병인105례，행상복부 CT 증강소묘。기중남85례，녀20례。을간간경화99례，주정성간경화3례，어혈성간경화2례，약물성간경화1례。령선비간경화병인작위대조조，공75례，남50례，녀25례。사용 GE 공사쌍원 CT。대비제사용전해순（350 mgl/ ml）고압주사。증강소묘시대비제량안1.4ml/ kg 정맥주사，주사속도설정위4.5ml/ s。동맥기소묘시간위복주동맥강화봉치시간연지2s，문정맥기적소묘시간이측득소제량예주사봉치시간상응연지3s、5s、7s、9s。도상중채용 MPR、MIP、VR 삼유중건급곡면중건。축위상급중건도상결합분석문정맥측지순배적해부로경。결과105례피검자문정맥측지개방통로중상견통로유：위저급위소만측정맥곡장74.29%，식관정맥곡장48.57%，부제정맥개방점25.71%。결론 MPR、MIP、VR 중건방법능구흔호지현시문정맥측지순배통로적해부특점，기중이위저、위체부곡장정맥최위다견，시문정맥고압측지순배개방정황적정위、정성진단적유효공구。
Objective:To analyze the anatomic characteristics of collateral pathways in patients with portal hyperten-sion. Methods:From January 2014 to May 2015,the 105 patients with portal hypertension were diagnosed by clinic,labo-ratory examination,ultrasonic and endoscopy,and were explained to undergo CT test. There were 85 males and 20 fe-males,and portal hypertension was induced by liver cirrhosis which was due to Virus B hepatitis(n = 99),alcohol(n =3),constrictive pericarditis(n = 2),and drug-induced hepatitis(n = 1). The control group was composed of the same pa-tients with non liver cirrhosis. All the CT scans were performed on GE dual-source CT. Contrast agent(non-ionic contrast agent iohexol 350 mgl/ ml )was injected by double tube high pressure syringe at a rate of 4. 5ml/ s. The volume of contrast medium was intravenously injected according to the body weight of patients(1. 4ml/ kg)during the formal scan and the up-per limit was 120 ml. The trigger time of arterial phase was 2 seconds later than the time of peak enhancement of aorta,and portal venous scan was triggered at 3s,5s,7s ,9s after the peak time of portal vein respectively. All the primary imagings were reconstructed by using Multiplanar Reconstruction(MPR),Maximun Intensity Projection(MIP)and Volum Recon-straction(VR)in Syngo MultiModality Workplace. All the anatomic structures were analyzed,combined with the axial and reconstructed pictures. Results:In 105 cases,the most commen varices included:the gastric varices accounting for 74. 29% ,esophageal varices 48. 57% ,paraumbilical vein 25. 71% . Conclusion:MSCTP and the reprocessing reconstruction are effective methods to display the anatomy structure of portal collaterals,which will help for making the localized and qualitative diagnosis. The most common varices are gastroesophageal and paraumbilical varices.
