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目的研究多层螺旋CT血管成像(CTA)在门静脉高压患者上腹部分流侧支血管显示中的作用。资料与方法对126例门静脉高压患者行门静脉系统及侧支血管的CTA检查。结果126例中,CTA提示各类食管静脉曲张108例(85.7%),胃底静脉曲张117例(92.9%),单纯食管静脉曲张8例(6.3%),食管静脉曲张合并胃体部静脉曲张1例(0.8%),食管静脉曲张合并胃底静脉曲张99例(78.6%),单纯胃底静脉曲张18例(14.3%)。胃左静脉显示120例(95.2%),附脐静脉显示26例(20.6%),胃网膜静脉显示10例(7.9%)。发现脾肾分流道4例(3.2%),胃左肾分流道35例(27.8%)。结论门静脉CTA可以清晰显示门静脉高压患者食管、胃底静脉曲张及主要侧支血管的走行、分布,为临床治疗方案的选择和疗效的观察评估提供有价值的影像学依据。
Objective To investigate the role of multi-slice spiral CT angiography (CTA) in the display of the shunt of upper abdomen in patients with portal hypertension. Materials and Methods CTA examination of portal vein system and collateral vessels was performed in 126 patients with portal hypertension. Results Of the 126 cases, CTA showed 108 cases (85.7%) of esophageal varices, 117 cases (92.9%) of gastric varices, 8 cases (6.3%) of simple esophageal varices, esophageal varices complicated with gastric varices 1 case (0.8%), 99 cases (78.6%) of esophageal varices complicated by gastric varices, and 18 cases (14.3%) of simple gastric varices. Left gastric venous showed 120 cases (95.2%), with umbilical vein showed 26 cases (20.6%), gastric retinal vein showed 10 cases (7.9%). Spleen and kidney shunt found in 4 cases (3.2%), gastric left renal shunt 35 cases (27.8%). Conclusions Portal vein CTA can clearly show the esophageal and gastric fundus varices and the movement and distribution of major collateral vessels in patients with portal hypertension, and provide valuable imaging evidence for the selection of clinical treatment options and the evaluation of curative effect.