AIM:To identify the characteristics of morphology, loca- tion and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomograghy (MDCT...AIM:To identify the characteristics of morphology, loca- tion and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomograghy (MDCT). METHODS: Fifty-two of 501 patients with portal hypertensive cirrhosis accompanied with esophageal varices were selected for 64-row MDCT examination af- ter the observation of para-EV. The CT protocol includ- ed unenhanced, arterial and portal phases with a slice thickness of 0.625 mm and a scanning field of 2 cm above the bifurcation to the lower edge of kidney. The CT portal venography (CTPV) was reformatted on AW4.3 workstation. The characteristics of origina- tion, location, morphology and collateral circulation in para-EV were observed. RESULTS: Among the 52 cases of para-EV, 50 showed the originations from the posterior branch of left gastric vein, while the others from the anterior branch. Fifty cases demonstrated their locations close to the esoph- ageal-gastric junction, and the other two cases were extended to the inferior bifurcation of the trachea. The circuitous pattern was observed in 16 cases, while reticulated pattern was seen in 36 cases. Collateral circulation identifi ed 4 cases of single periesophageal varices (peri-EV) communication, 3 cases of single hemiazygous vein, one case of single inferior vena cava, 41 cases of mixed type (collateral communica-tions of at least 2 of above mentioned types) and 3 cases of undetermined communications. Among all the cases, 43 patients showed the communications between para-EV and peri-EV, while hemiazygous vein (43 cases) and inferior vena cava (5 cases) were also involved. CONCLUSION: Sixty-four-row multidetector computed tomograghy portal venography could display the loca- tion, morphology, origin, and collateral types of para- EV, which provides important and referable information for clinical management and disease prognosis.展开更多
AIM:To study characteristics of collateral circulation of gastric varices (GVs) with 64-row multidetector computer tomography portal venography (MDCTPV).METHODS:64-row MDCTPV with a slice thickness of 0.625 mm and a s...AIM:To study characteristics of collateral circulation of gastric varices (GVs) with 64-row multidetector computer tomography portal venography (MDCTPV).METHODS:64-row MDCTPV with a slice thickness of 0.625 mm and a scanning field from 2 cm above the tracheal bifurcation to the lower edge of the kidney was performed in 86 patients with GVS diagnosed by endoscopy. The computed tomography protocol included unenhanced,arterial and portal vein phases. The MDCTPV was performed on an AW4.3 workstation. GVs were classified into three types according to Sarin's Classification. The afferent and efferent veins of each type of GV were observed.RESULTS:The afferent venous drainage originated mostly from the left gastric vein alone (LGV) (28/86,32.59%),or the LGV more than the posterior gastric vein/short gastric vein [LGV > posterior gastric vein/short gastric vein (PGV/SGV)] (22/86,25.58%),as seen by MDCTPV. The most common efferent venousdrainage was via the azygos vein to the superior vena cava (53/86,61.63%),or via the gastric/splenorenal shunt (37/86,43.02%) or inferior phrenic vein (8/86,9.30%) to the inferior vena cava. In patients with gastroesophageal varices type 1,the afferent venous drainage of GV mainly originated from the LGV or LGV > PGV/SGV (43/48,89.58%),and the efferent venous drainage was mainly via the azygos vein to the super vena cava (43/48,89.58%),as well as via the gastric/splenorenal shunt (8/48,16.67%) or inferior phrenic vein (3/48,6.25%) to the inferior vena cava. In patients with gastroesophageal varices type 2,the afferent venous drainage of the GV mostly came from the PGV/SGV more than the LGV (PGV/SGV > LGV) (8/16,50%),and the efferent venous drainage was via the azygos vein (10/16,62.50%) and gastric/splenorenal shunt (9/16,56.25%). In patients with isolated gastric varices,the main afferent venous drainage was via the PGV/SGV alone (16/22,72.73%),and the efferent venous drainage was mainly via the gastric/splenorenal shunt (20/22,90.91%),as well as the inferior phrenic vein (3/23) to the in展开更多
Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance ...Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography （MRV） in the evaluation of the recanalization of CVST. Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight （2D-TOF） MRV in thirty-two consecutive patients during a threeto six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography （DSA） were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard. Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% （62/68）, 93% （37/40）, 95% （62/65）, and 86% （37/43） respectively. Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.展开更多
基金The Science Technology Program of Beijing Education Committee, No.KM200810025002
文摘AIM:To identify the characteristics of morphology, loca- tion and collateral circulation involved in paraesophageal varices (para-EV) of portal hypertension patients with 64-row multidetector computed tomograghy (MDCT). METHODS: Fifty-two of 501 patients with portal hypertensive cirrhosis accompanied with esophageal varices were selected for 64-row MDCT examination af- ter the observation of para-EV. The CT protocol includ- ed unenhanced, arterial and portal phases with a slice thickness of 0.625 mm and a scanning field of 2 cm above the bifurcation to the lower edge of kidney. The CT portal venography (CTPV) was reformatted on AW4.3 workstation. The characteristics of origina- tion, location, morphology and collateral circulation in para-EV were observed. RESULTS: Among the 52 cases of para-EV, 50 showed the originations from the posterior branch of left gastric vein, while the others from the anterior branch. Fifty cases demonstrated their locations close to the esoph- ageal-gastric junction, and the other two cases were extended to the inferior bifurcation of the trachea. The circuitous pattern was observed in 16 cases, while reticulated pattern was seen in 36 cases. Collateral circulation identifi ed 4 cases of single periesophageal varices (peri-EV) communication, 3 cases of single hemiazygous vein, one case of single inferior vena cava, 41 cases of mixed type (collateral communica-tions of at least 2 of above mentioned types) and 3 cases of undetermined communications. Among all the cases, 43 patients showed the communications between para-EV and peri-EV, while hemiazygous vein (43 cases) and inferior vena cava (5 cases) were also involved. CONCLUSION: Sixty-four-row multidetector computed tomograghy portal venography could display the loca- tion, morphology, origin, and collateral types of para- EV, which provides important and referable information for clinical management and disease prognosis.
基金Supported by The Science Technology Program of Beijing Education Committee, No. KM200810025002
文摘AIM:To study characteristics of collateral circulation of gastric varices (GVs) with 64-row multidetector computer tomography portal venography (MDCTPV).METHODS:64-row MDCTPV with a slice thickness of 0.625 mm and a scanning field from 2 cm above the tracheal bifurcation to the lower edge of the kidney was performed in 86 patients with GVS diagnosed by endoscopy. The computed tomography protocol included unenhanced,arterial and portal vein phases. The MDCTPV was performed on an AW4.3 workstation. GVs were classified into three types according to Sarin's Classification. The afferent and efferent veins of each type of GV were observed.RESULTS:The afferent venous drainage originated mostly from the left gastric vein alone (LGV) (28/86,32.59%),or the LGV more than the posterior gastric vein/short gastric vein [LGV > posterior gastric vein/short gastric vein (PGV/SGV)] (22/86,25.58%),as seen by MDCTPV. The most common efferent venousdrainage was via the azygos vein to the superior vena cava (53/86,61.63%),or via the gastric/splenorenal shunt (37/86,43.02%) or inferior phrenic vein (8/86,9.30%) to the inferior vena cava. In patients with gastroesophageal varices type 1,the afferent venous drainage of GV mainly originated from the LGV or LGV > PGV/SGV (43/48,89.58%),and the efferent venous drainage was mainly via the azygos vein to the super vena cava (43/48,89.58%),as well as via the gastric/splenorenal shunt (8/48,16.67%) or inferior phrenic vein (3/48,6.25%) to the inferior vena cava. In patients with gastroesophageal varices type 2,the afferent venous drainage of the GV mostly came from the PGV/SGV more than the LGV (PGV/SGV > LGV) (8/16,50%),and the efferent venous drainage was via the azygos vein (10/16,62.50%) and gastric/splenorenal shunt (9/16,56.25%). In patients with isolated gastric varices,the main afferent venous drainage was via the PGV/SGV alone (16/22,72.73%),and the efferent venous drainage was mainly via the gastric/splenorenal shunt (20/22,90.91%),as well as the inferior phrenic vein (3/23) to the in
文摘Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography （MRV） in the evaluation of the recanalization of CVST. Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight （2D-TOF） MRV in thirty-two consecutive patients during a threeto six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography （DSA） were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard. Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% （62/68）, 93% （37/40）, 95% （62/65）, and 86% （37/43） respectively. Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.
