PDF下载 ( 748 KB)
Diagnostic Value of Multi-slice CT in Pancreatogenic Segmental Portal Hypertension and a report of 42 cases
-
摘要: 目的分析胰源性区域性门静脉高压(pancreatogenic segmental portal hypertension,PSPH)的多层螺旋CT(MSCT)表现,探讨MSCT对该病的诊断价值。方法使用16排螺旋CT对42例PSPH患者行上腹部CT平扫及增强扫描,采用图像后处理技术显示脾静脉及侧枝血管情况。结果孤立性脾静脉阻塞30例,其侧支血管食管静脉(9.5%)、胃冠状静脉(76.19%)、胃短静脉(85.71%)、胃网膜静脉(95.24%)、胃结肠干(23.81%)曲张;非孤立性脾静脉栓塞12例,其中伴肠系膜上静脉阻塞8例,其属支胃结肠干(19.05%)、结肠右上静脉(16.67%)、结肠中静脉(14.29%)、胰十二指肠前上静脉(19.05%)有不同程度曲张。伴门静脉海绵样变5例。结论MSCT对PSPH的脾静脉阻塞及其胃周迂曲扩张的侧枝静脉显示具有重要价值。Abstract: Objective To analyze MSCTfeatures of PSPHand to evaluate the value of MSCT in clinical settings and imaging diagnosis of PSPH.Methods A 16-detector row spiral CT scanner was used to perform plain and muti-phase contrast enhanced abdominal scanning in 42 patients with PSPH.Various image post-processing techniques were applied to depict abnormal splenic vein and the collateral vessels of PSPH.Results In 30 cases with isloated splenic vein occlusion, esophageal vein (EV, 9.5%) , coronary gastric vein (CGV, 76.19%) , short gastric vein (SGV, 85.71%) gastroepiploic vein (GEV, 95.24%) and gastrocolic trunk (GCT, 23.81%) were varicose and dilated, respectively.In 12 non-isloated splenic vein occlusion, associated with 8 cases SMV occlusion, other collateral veins such as gastrocolic trunk (GCT, 19.05%) , the right superior colic vein (RSCV, 16.67%) , middle colic vein (MCV, 14.29%) and anterior superior pancreaticoduodenal vein (ASPDV, 19.05%) were seen as well.Meanwhile 5 cases assoicated with cavernous transformation of portal vein.Conclusion MSCT and image post-processing techniques are of great value for the diagnosis of PSPH in Splenic vein occlusion and collateral vessels around.
-
Key words:
- pancreatic diseases /
- splenic vein /
- portal hypertension /
- collateral circulation /
- tomography
-
[1]宋彬, 闵鹏秋, 周翔平, 等.胰头静脉弓的CT研究[J].中华放射学杂志, 1997, 31 (9) ∶603-607. [2]Marn CS, Glazer GM, Williams DM, et al.CTangiographic correla-tion of collateral venous pathways in isolated splenic veinocclusion:new observations[J].Radiology, 1990, 1759 (2) ∶375-380. [3]Liu QD, Zhou NX, Zhang WZ, et al.Diagnosis and Management ofRegional Portal Hypertension[J].Chin J Dig Dis, 2005, 6 (2) ∶87-92. [4]Mori H, Mcgrath FP, Malone DE, et al.The gastrocolic trunk andits tributaries:CTevaluation[J].Radiology, 1992, 182 (3) ∶871-877. [5]吴芯, 宋彬, 陈卫霞.胰源性脾静脉阻塞侧支循环的螺旋CT表现[J].中国普外基础与临床杂志, 2003, 10 (6) ∶619-622. [6]Leach SD, lee JE, Charnsangavej C, et al.Survival following pan-creaticodenectomy with resection of the superior mesenteric-portalvein confluence for adenocarcinoma of the pancreashead[J].Br JSurgery, 1998, 85 (5) ∶611-617. [7]Hommeyer S, Freeny P, Crabo L.Carcinoma of the head of the pan-creas:evaluation of thepancreaticoduodenal veins with dynamic CT-potential for improved accuracy in staging[J].Radiology, 1995, 196 (1) ∶233-238. [8]K klüS, Yüksel O, Arhan M, et al.Report of 24 left-sided portalhypertension cases:A single-center prospective cohort study[J].Dig Dis Sci, 2005, 50 (5) ∶976-982. [9]戴存才, 苗毅, 刘训良, 等.胰源性肝外门静脉高压症八例[J].中华肝胆外科杂志, 2005, 12 (4) ∶235-236. -
本文二维码
计量
- 文章访问数: 2222
- HTML全文浏览量: 13
- PDF下载量: 795
- 被引次数: 0
下载:
