摘要
目的探讨64层螺旋CT在分型诊断儿童原发性门静脉海绵样变性(CTPV)中的价值。方法回顾性分析37例经手术证实为原发性CTPV患儿的临床及CT资料,分别行MIP、VR、MPR重建,观察其特征性血管表现,根据病变累及范围及部位对CTPV进行分型。结果 37例中,CTPV的侧支血管范围及程度均获显示。8例Ⅰ型CTPV,海绵样变性仅发生于肝内门静脉左和(或)右分支;18例Ⅱ型CTPV,表现为Ⅰ型合并门静脉主干狭窄或消失;11例Ⅲ型CTPV,海绵样性变在Ⅱ型病变基础上进一步累及肠系膜上静脉及脾静脉。3例Ⅰ型CTPV患儿接受肝移植术;18例Ⅱ型CTPV,15例接受门-体静脉分流术,3例辅以脾切除及贲门血管离断术;8例Ⅲ型CTPV接受脾切除和贲门周围血管离断术。结论 64层螺旋CT对于诊断儿童原发性CTPV具有重要应用价值;MSCT分型对选择手术治疗方式、预后判断有较为重要的指导意义。
Objective To explore the value of 64-slice MSCT for primary cavernous transformation of portal vein （CTPV） in pediatric patients, and to observe clinical significances of MSCT classification of CTPV. Methods Clinical and 64-slice MSCT data of 37 children with idiopathic CTPV confirmed by surgery were retrospectively analyzed. All MSCT ima-ges were reconstructed with VR, MIP and MPR, then the characteristics of blood vessels were observed, and the patients were classified according to the range and site of CTPV. Results Thrombosis location, degree and collateral vessels were displayed in all patients. There were 8 cases of type Ⅰ CTPV （cavernous transformation only occurred on right and/or left branch of portal vein）, 18 cases of type Ⅱ （cavernous transformation happened on both branches of portal vein and the main portal vein） and llcases of type Ⅲ CTPV （type Ⅱ accompanied with involvement of superior mesenteric vein and splenic vein）. Liver transplantation was preferred in 3 cases of type I CTPV. Among 18 cases of type Ⅱ CTPV, portosys-temic shunt was established in 15 cases, while accompanied splenectomy and pericardical devascutarization were performed in 3 cases. Splenectomy and pericardical devascularization were also chosen for treatment of 8 patients with type Ⅲ CTPV. Conclusion 64-slice MSCT is of vital importance in diagnosis of children with primary CTPV. MSCT classification of CT-PV can provide important information for surgery operation and prognosis of primary CTPV in children.
出处
《中国医学影像技术》
CSCD
北大核心
2014年第5期653-656,共4页
Chinese Journal of Medical Imaging Technology
基金
重庆市自然科学基金(CSTC 2010BB 5379)
重庆市医学科技计划(2008-2-172)
