64层螺旋CT对门静脉海绵样变性的诊断价值

目的探讨64层螺旋CT在门静脉海绵样变性（CTPV）诊断中的价值。方法对CT检查发现的CTPV患者22例,采用MPR、MIP、VR等图像后处理技术显示异常的门静脉及侧支血管情况。结果 22例CTPV在CT平扫上显示门静脉结构不清,肝门区可见多发的结节状、条状软组织影。增强扫描显示6例动脉期肝实质灌注异常;门静脉期11例患者门静脉主干和（或）左右分支增粗,内可见充盈缺损,4例门静脉显示不清;2例门静脉主干和（或）左右分支在正常范围内;4例门静脉主干变细;1例门静脉主干受侵致管腔狭窄。胆管周围静脉丛（86.36%）、胆囊静脉（77.27%）及食管胃底静脉（77.27%）呈点状、细网状、簇状扩张。结论 64层螺旋CT能准确显示CTPV的部位、范围,立体地显示各曲张血管的走行及曲张程度,是检查CTPV的有效手段。

Value of 64-slices spiral computed tomography in the diagnosis of cavernous transformation of portal vein

Objective To investigate the value of 64-slice spiral computed tomography in the diagnosis of cavemous transformation of portal vein(CTPV.) Methods A 64-slices spiral CT scanner was used to perform plain and three-phase contrast enhanced abdominal scanning in 22 patients with CTPV.Image post-processing techniquesi,ncluding MPR,MIP and VR,were applied to depict the abnormal portal vein and its collateral vessels.Results The portal vein was not clearly seen on plain in 22 cases,while multiple soft tissue nodules and strips were found in the porta hepatis region.On dynamic enhanced scansa,bnormal hepatic perfusion during arterial phase in 6 cases was demonstrated.On portal vein phase images the main trunk of portal vein and/or its left and right branches were dilated with filling defects in 11 cases.Inconspicuous portal veins were demonstrated.The main trunk of portal vein looked thin in 4 cases.The main trunk of portal vein was lumen stenosis as a result of tumor-infiltrating in 1 case.Pericholedochal venous plexus(86.36%)c,ystic vein(77.27%)and esophageal gastric veins(77.27%)were dilated and varicose,looking like clusters of spots and reticule.The courses and extents of the varicose vessels were directly demonstrated with MPR,MIP and VR techniques.Conclusion 64-slice spiral computed tomography can accurately show the location and the extent of CTPV.It can also optimize the collateral vessels of CTPVs,o it is an effective examination method to diagnose CTPV.