严重肝硬化离肝性门静脉侧枝通路:以CT门静脉图确认
Hepatofugal Collaterals in Advanced Liver Cirrhosis: Identification with CT Portography
姜仁惠;李润川;黄姗姒;曾修山;邱怡友;王家槐;刁翠美;周宜宏;张政彦;邓木火
放射线学科 期刊名称(journal):
中华放射线医学杂志
卷(vol.):
vol.31
期(issue.):
Issue. 1
年代(year.):
2006
摘要:
重度肝硬化病人病程缓慢却多合并发生门静脉高血压症.病人门静脉血压增高,向肝性血行 渐减,久之,曲张之侧枝循环静脉於是形成.在临床上,医师事先能确认病人之门静脉血行 状况及侧枝静脉图谱,对於治疗计画之拟定有极大的帮助.近年来,多切面电脑断层摄影配 合静脉注射对比剂技术,对重度肝硬化病人提供品质极为优异的门静脉及其侧枝静脉图谱. 自2004年元月至同年12月,本院148位肝硬化病人,利用16切面电脑断层摄影机施行CT门静脉摄 影检查,其中112人显示为重度肝硬化合并门静脉高血压症性离肝性静脉侧枝循环.研究显示 它确实提供全方位高品质之侧枝循环静脉图谱.对於侧枝静脉之确认以及治疗方向之选择, 提供极为珍贵和正确的资料.
Abstract:
Portal hypertension is a common syndrome that is characterized by pathologic increase in portal venous pressure and by the formation of portal systemic collaterals that shunt part of portal venous blood to the systemic circulation. Knowledge of hemodynamic circulation and portal venous collateral pathways is important for clinical physicians. Multi-detector row computed tomography (CT) offers important advantages over conventional imaging methods in the evaluation of the portal venous vasculature because of faster scanning and thinner collimation. These advances allow excellent visualization of the portal veins and hepatofugal collateral channels. Three-dimensional CT portography may also have technical potential to generate excellent image for volumetric reconstructions and hemodynamic evaluation of the portal vein and its collaterals. From January to December 2004, 148 patients with liver cirrhosis were enrolled for this study and hepatofugal collaterals were identified in 112 patients. Three-dimensional CT portography provided comprehensive mapping of vascular compromise and collateral formation and therefore, improved medical treatment quality.