动态对比增强MRA对门静脉海绵样变性的诊断

目的:探讨动态对比增强(DCE)MRI和对比增强MRA(DCE-MRA)诊断门静脉海绵样变性(CTPV)的价值及临床意义。方法:28例CTPV患者均行MR动态对比增强及动态对比增强MRA检查,分析所有病例MR动态增强、DCE-MRA表现及特征。结果:CTPV的MRI平扫时可见门静脉闭塞,闭塞门静脉周围可见由侧支静脉形成的团块状、网状异常软组织信号影。动态MR增强动脉期见肝实质灌注异常,门静脉期见异常侧支静脉强化,3DDCE-MRA显示上述异常改变,行DSA检查病例DCE-MRA与DSA表现一致。结论:CTPV具有特征性的MR动态增强、DCE-MRA表现,对CTPV的诊断及鉴别诊断具有重要价值,对临床制定治疗方案具有重要意义。     

三维动态增强MR血管成像对门静脉海绵样变性的诊断

目的分析门静脉海绵样变性（CTPV）在三维动态增强磁共振血管成像（3D—DCEMRA）上的表现和特征,并评价其诊断价值。方法回顾性分析了经临床及DSA检查证实的11例门静脉海绵样变性的3D—DCEMRA的特征性表现。结果本组11例CTPV中,门静脉主干闭塞见于6例,门静脉主干及左右支均受累者3例,单纯左支或右支闭塞2例。9例3D—DCEMRA清楚地显示了数条迂曲的侧支循环静脉跨过阻塞部位向肝内匐形延伸,其中7例可在网状扩张的门静脉腔内显示细条状、小点状低信号血栓影,6例清楚地显示门静脉全程多条细小迂曲的侧支循环静脉缠绕在一起,扭曲成网状的血管结构。结论3D—DCEMRA能准确地提供CTPV的位置、严重程度等信息,可直观地评价本病,为临床采取正确的治疗措施提供可靠依据。     

门静脉海绵样变性的MRI诊断

目的 探讨门静脉海绵样变性(CTPV)的MR平扫及动态增强、动态对比增强MRA(DCE-MRA)的表现，评价MRI诊断CTPV的价值及临床意义。资料与方法 分析28例CTPV患者的MR平扫、动态增强或DCB-MRA资料，所有病例均经手术病理或DSA证实。结果 CTPV的MRI表现：平扫时可见门静脉闭塞，闭塞门静脉周围可见由侧支静脉形成的团块状、网状异常软组织信号影。动态MR增强动脉期见肝实质灌注异常，门静脉期见异常侧支静脉强化，DCE-MRA显示上述改变更直观。结论 MR平扫及动态增强、DCE-MRA表现对CTPV具有重要的诊断价值。     

脑静脉瘤的MRI诊断

对８例脑静脉瘤的ＭＲＩ信号进行了分析，结果表明静脉瘤Ｔ１加权像为低信号流空，Ｔ２加权像主要为高信号。全部８例均显示管状或条状走行的引流静脉，３例清楚显示伞状汇聚的髓质静脉与引流静脉相连，３例显示多条细小的血管与引流静脉相邻近，但未显示典型伞状汇聚征象，１例行Ｇｄ－ＤＴＰＡ增强扫描，显示典型髓质静脉汇聚于引流静脉，呈明显强化表现。作者认为，磁共振检查有助于静脉瘤的诊断，特别是ＭＲＩ增强扫描可以清楚显示其结构，可作为首选的影像学检查。     

动态增强磁共振门静脉造影在门脉高压症诊断中的价值

目的:探讨动态增强磁共振门静脉造影(DCE MRP)在门脉高压症诊断中的价值。方法:对门脉高压症组23例和正常对照组15例行DCE MRP检查。观察23例门静脉高压症在DCE MRP上的表现。结果:对照组15例均清楚显示门静脉。门脉高压症表现为门静脉增粗(21例)、脾静脉迂曲扩张(23例);门静脉分支级数减少(18例);门静脉延迟显影(7例);显示侧枝循环静脉(6例);门静脉血栓形成(3例)。结论:DCE MRP是评价门静脉的一项快速无创的技术,可准确显示门静脉高压症门静脉系统的病理改变。     

门静脉海绵样变性彩色多普勒的诊断

彩色多普勒血流显像 (ＣＤＦＩ)的广泛应用对门静脉海绵样变性 (ｐｏｒｔａｌｖｅｉｎｃａｖｅｒｎｏｕｓｔｒａｎｓｆｏｒｍａｔｉｏｎ ,ＰＶＣＴ)诊断准确性及其鉴别诊断明显提高。现将我院自 1 998年 1月～ 2 0 0 0年 1 2月 ,经过ＣＤＦＩ诊断为ＰＶＣＴ的 1 0例 (通过手术病理证实的 4例 ,经ＣＴ、ＭＲＩ证实的 6例 )报告如下。1　材料与方法　　本组 1 0例中 ,男性 8例 ,女性 2例 ,年龄 6～ 75岁 ,平均44 .5岁。超声检查前禁食 8～ 1 2ｈ。患者取仰卧及左侧卧位 ,探头置于右肋间、肋下及剑下作纵、横、斜多切面扫查 ,以显示门脉主干及…     

门静脉瘤的影像学诊断(附5例报道)

目的:探讨门静脉瘤的影像学表现、发病机制以及各种影像学检查方法在该病诊断中的价值.方法:对经CT确诊的5例门静脉瘤的病例资料进行回顾性分析,比较CT、MR和超声检查对本病的诊断价值.结果:门静脉瘤的主要影像学表现是门静脉主干或其分支的局限性扩张,好发部位为血管交汇处,可伴有其它血管畸形.5例中肝内型3例、肝外型2例.2例合并有肝硬化,其中1例伴有门静脉高压和肝动脉-门静脉瘘,另1例伴有原发性肝癌(HCC);3例无肝硬化征象者,1例伴有门静脉双干畸形,1例伴有脾肿大但无肝硬化门静脉高压表现,1例未发现其它伴发病变.结论:超声、CT和MRI均可对本病做出定位、定性诊断,MSCTA能提供更为直观地三维图像,因而具有更重要的诊断价值.     

5例门静脉瘤的MSCT表现分析

<正>门静脉瘤(protal vein aneurysm,PVA)以往临床上极为少见,但随着医学影像技术的发展及对本病认识的提高,近年来发现的患者有所增加。现收集5例PVA并复习相关文献,对其SCT表现进行探讨,以进一步提高对该病的认识。     

门静脉海绵样变性的影像学表现

随着影像学检查技术的发展,门静脉海绵样变性（cavernous transformation of the portal vein,CTPV）的检出率越来越高,B超、CT、MRI、MRA、DSA等各项检查手段在CTPV诊断中发挥了重要作用。充分理解CTPV病因、发病机制,认识其影像学表现在CTPV的诊治中发挥了日益重要的作用。     

门静脉海绵样变性的CT诊断及临床意义

目的 :分析门静脉海绵样变性病人的 CT表现和特征 ,探讨 CT诊断该病的价值及临床意义。方法 :对 2 6例经 DSA,手术或 US证实且均做腹部 CT平扫和增强扫描门静脉海绵样变性病人进行回顾性分析。结果 :主要 CT表现为门静脉走行区结构紊乱 ,正常结构消失 ;在门静脉走行区出现血管或迂曲、扩张窦隙样血管结构 ,其在门静脉期明显强化。在动脉期 ,可见到周围肝实质短暂灌注异常 ,表现为带状高密度影 ,而在静脉期迅速消失。结论 :CT是诊断门静脉海绵样变性的有效方法。认识门静脉海绵样变性的 CT特征对避免错误的 CT诊断及指导临床制定正确的治疗计划都具有重要的意义     

门静脉海绵样变性的螺旋CT诊断

目的：探讨门静脉海绵样变性(CTPV)的CT表现，以提高对本病的认识方法回顾性分析经数字减影血管造影、手术或US证实的CTPV 25例。25例均行CT平扫及双期增强扫描。结果：CTPV螺旋CT表现：a)门静脉狭窄和阻塞；b)门脉走行区结构紊乱，正常结构消失，出现迂曲扩张血管样结构，门静脉期明显强化；c)在动脉期可见周围肝实质短暂灌注异常，表现为局部或带状高密度。结论：CTPV螺旋CT双期扫描具有一定的特征性表现，正确诊断有赖于结合临床资料和影像学征象的综合分析。     

TIPSS技术在门脉癌栓性门脉高压中的应用

目的 探讨TIPSS技术在治疗门静脉癌栓合并门脉高压中的技术特点及禁忌证。方法 16例门静脉癌栓合并门脉高压症患者，9例门静脉主干完全堵塞，7例门静脉主干及分支有不同程度栓塞；6例合并门脉海绵样变；1例单纯上消化道大出血；4例单纯顽固性腹水；11例上消化道大出血合并顽固性腹水。结果 16例中11例患者成功行TIPSS治疗，技术成功率约68.8%，门脉压力从术前4.9kPa降至2.4kPa，平均降低2.5kPa，腹水减少或消失，症状缓解。平均生存136d。5例失败。结论 TIPSS是治疗门脉癌栓引起的上消化道大出血和顽固性腹水的有效方法，门脉海绵样变是该术的禁忌证。     

彩色多普勒超声诊断门静脉海绵样变性

目的探讨门静脉海绵样变性（CTPV）的彩色多普勒超声的声像图特征及诊断价值。方法将彩色多普勒超声诊断为CTPV的19例患者与血管造影、CT和MRI及部分手术结果进行对照。结果彩超诊断符合率100％。彩超显示门静脉主干及分支周围呈蜂窝状、多条迂曲扩张的管状无回声,内充满红蓝相间彩色血流信号,脉冲多普勒示无回声内血流信号为门静脉样低速血流频谱。结论CTPV的彩色多普勒超声声像图具有特征性表现,彩超诊断CTPV准确率高,简便,无痛苦,具有重要的临床应用价值。     

A rare pediatric case of portal vein aneurysm thrombosis

Portal vein aneurysm (PVA) is rarely encountered, and published papers describing this etiology in adults and children typically include only case reports or small case series. We present a clinical case of PVA in a child associated with severe complications, including diffuse thrombosis of the portal venous system. A 10-year-old boy presented with abdominal pain and vomiting, resulting in an initial diagnosis of pancreatic head tumor based on suspicious images on abdominal grayscale ultrasound. Contrast-enhanced computed tomography confirmed a diagnosis of occlusive PVA thrombosis (36 × 37 × 95 mm). Lacking drastic symptoms, the patient was treated with conservative anticoagulant therapy. On follow-up, the thrombosis appeared to shrink gradually and disappeared at 6 months based on Doppler ultrasound imaging. The PVA was reduced in size, and hepatopetal flow was restored. Surgeons and radiologists should be aware of this rare entity to ensure that a precise diagnosis can be established and to provide suitable treatment.     

Congenital absence of portal vein with nodular regenerative hyperplasia of the liver

Congenital absence of the portal vein is a very rare anomaly. The intestinal and splenic venous drainage bypasses the liver and drain into the inferior vena cava (IVC). Two cases of such anomaly are described. Both cases were investigated by US coupled with echo-colour Doppler examination, CT and MR imaging, followed by digital subtraction angiography (DSA) and liver biopsy. In the first case the splenic and superior mesenteric vein formed a venous trunk which emptied directly into the IVC; in the second case, the splanchnic blood flowed into a dilated hepatofugal inferior mesenteric vein which connected to the left internal iliac vein. In both cases nodular regenerative hyperplasia of the liver was present, presumably due to an abnormal hepatic cell response to the absent portal flow. The particular contribution of MR imaging to the diagnosis of both vascular abnormalities and liver parenchyma derangement and its advantages over the other diagnostic techniques is emphasized. The clinical and radiological features of 17 previously reported cases are reviewed. Received: 22 September 1998; Revised: 21 January 1999; Accepted: 22 April 1999     

Diagnosis of an accessory portal vein and its clinical implications for portosystemic shunts

Purpose To present a peculiar anatomic portal veins variant and evaluate its clinical implications. Methods Among 118 consecutive patients undergoing transjugular intrahepatic portosystemic shunting (TIPS), six male patients were found to have an accessory portal vein, which was seen during direct portography. Results In all six patients, portograms showed an accessory small-caliber vein parallel to the trunk of the main portal vein ending in the right lobe of the liver. Two of the six accessory portal veins drained blood from coronary veins, precluding access to coronary vein embolization during TIPS. Conclusion An accessory portal vein is a rare anatomical variation with clinical significance for both surgical shunt placement and TIPS, as well as for transportal embolization of coronary veins.     

Transarterial embolization of an extrahepatic portal vein aneurysm with arterioportal fistula

We successfully performed transcatheter arterial embolization of an extrahepatic arterioportal fistula with a portal vein aneurysm. The fistula was considered secondary to cholecystectomy for cholecystolithiasis 5 years earlier. After occlusion of the fistula with platinum coils, the aneurysmal cavity thrombosed.