多层螺旋CT血管造影在胰源性区域性门静脉高压症诊断中价值研究

摘要

目的 研究分析多层螺旋CT血管造影(MSCTA)在胰源性区域性门静脉高压症(PSPH)诊断中的价值.方法 选择本院收治的PSPH患者40例的临床及影像资料,全部患者均给予MSCTA检查及彩色多普勒超声检查,观察2种方法对门静脉(PV)系统血管显示情况,采用4级评分法对血管显像进行评级,并进行组间对比分析.结果 MSCTA检查中脾静脉(SV)、肠系膜上静脉(MSV)、PV显像血管评级为优良者分别为33例(82.5％)、34例(85.0)和37(92.5％)；彩色多普勒超声检查中,上述静脉血管评级为优良者分别为27例(67.5％)、28例(70.0％)和30(75.0％)；血管分级比较差异有统计学意义(P＜0.05)；全部患者MSCTA检查显示脾静脉狭窄或中断,PV主干、MSV及其分支均显示良好；胃冠状静脉(GCV)未受累及30例患者中,22例患者胃短静脉(GSV)、20例患者胃网膜静脉(GEV)、18例患者胃结肠干(GCT)均出现曲张表现；GCV受累及10例患者GCV、GSV、GEV、GCT均出现曲张扩张表现.结论 MSCTA可有效显示PSPH患者PV主干及侧支循环静脉情况,显像清晰可为临床诊断提供有效价值.%Objective To study and analyze the value of multi-slice spiral CT angiography (MSCTA) in the diagnosis of pancreatic sinistral portal hypertension (PSPH).Methods Clinical and imaging data of 40 PSPH patients were selected and the patients were all given MSCTA and Color Doppler ultrasound detection.The vascular situation of portal vein system was observed,the vascular imaging with 4 levels scoring method was evaluated,and the groups were compared.Results The imaging vascular of splenic vein (SV),superior mesenteric vein (MSV),portal vein (PV) detected by MSCTA rated excellent in 33 cases (82.5％),34 cases (85.0),37 (92.5％) ; in color Doppler ultrasound detection,the veins rated excellent in 27 cases (67.5％),28 cases (70.0％),30 (75.0 ％),and the difference was significant (P ＜0.05).MSCTA detection showed all patients had splenic vein stenosis or interruption,and portal vein,superior mesenteric vein and its branches showed good.Gastric coronary vein (GCV) was not involved in 30 patients,and short gastric vein(GSV) of 22 cases,gastroepiploic vein (GEV ) of 20 patients,gastrocolic trunk (GCT) of 18 patients were found with varicose performance.In 10 patients with GCV involvement,the GCV,GSV,GEV,GCT were all found with varicose dilatation performance.Conclusion MSCTA can effectively show portal vein and collateral circulation cava of PSPH patients,and clear imaging can provide a valid value in clinical diagnosis.