摘要
目的探讨肝硬化患者经颈静脉肝内门体静脉分流术(TIPS)相关血管解剖的CT血管造影(CTA)表现。方法回顾性分析上腹部CT增强扫描并符合入组标准者共64例,分为正常组(n=27)和肝硬化组(n=37)。采集原始图像进行图像后处理,观察肝内外门静脉分支和肝静脉分支的分型,测量肝静脉与下腔静脉夹角、肝静脉间夹角、肝外门静脉与肝实质接触面接触比例,以及肝外门静脉及其分支的长度、直径和夹角等。结果 64例中,肝静脉Ⅰ型占67.1%,Ⅱ型32.9%;肝硬化组肝右静脉与下腔静脉夹角和肝左静脉与下腔静脉夹角较正常组明显增大[(64.6±8.5)°vs (42.8±8.2)°,(69.7±9.7)°vs (55.6±6.3)°;P均<0.01],肝中静脉与肝左静脉夹角较正常组明显增大[(64.6±15.4)°vs (55.8±17.0)°;P=0.035];肝硬化组门静脉主干长度、门静脉主干直径较正常组有所增加[(56.0±12.0)mm vs (46.5±7.6)mm,(16.6±4.2)mm vs (14.0±2.4)mm;P均<0.01];肝硬化组门静脉左支与肝脏紧密接触面比例较正常组减小[(33.5±9.4)%vs (42.8±21.1)%;P=0.03],但门静脉左支顶部与肝组织仍紧密连接。结论肝硬化时,肝静脉、门静脉位置和形态均发生明显改变,CTA术前准确评估为设计手术方案提供基础。
Objective To investigate the CTA manifestations of vascular anatomy in patients with cirrhosis undergoing cervical intrahepatic portosystemic shunt(TIPS).Methods A total of 64 patients who underwent CT-enhanced CT scan and were eligible for retrospective analysis were divided into normal group(n = 27) and cirrhosis group(n = 37).The original image was collected for image post-processing,and the classification of the portal vein and hepatic vein branches in the liver and the outside was observed.The angle between the hepatic vein and the inferior vena cava,the angle between the hepatic vein,the ratio of contact between the extrahepatic portal vein and the liver parenchyma,and the liver were measured.The length,diameter and angle of the external portal vein and its branches.Results Among 64 cases,hepatic vein type Ⅰ accounted for 67.1%,type Ⅱ 32.9%;liver cirrhosis group right hepatic vein and inferior vena cava angle and left hepatic vein and inferior vena cava angle were significantly larger than normal group [(64.6±8.5) ° vs(42.8 ±8.2) °,(69.7±9.7) ° vs(55.6±6.3) °;P < 0.01],the angle between the hepatic vein and the left hepatic vein was significantly increased compared with the normal group [(64.6±15.4) ° vs(55.8±17.0) °;P = 0.035];the length of the portal vein and the diameter of the portal vein in the cirrhosis group were increased compared with the normal group[(56.0±12.0) mm vs(46.5±7.6) mm,(16.6)±4.2)mm vs(14.0±2.4)mm;P < 0.01];the ratio of the close contact between the left portal vein and the liver in the cirrhosis group was smaller than that in the normal group [(33.5 ±9.4) % vs(42.8±21.1) %;P = 0.03],but the top of the left branch of the portal vein is still tightly connected to the liver tissue.Conclusion The location and morphology of hepatic vein and portal vein have changed significantly during cirrhosis.Accurate evaluation before CTA provides the basis for designing the surgical plan.
作者
桑节峰
曹俊杰
周大勇
黄剑
黄献琛
沈利明
沈钧康
SANG Jiefeng;CAO Junjie;ZHOU Dayong(Department of Radiology,Ganyu people hospital,Lianyungang, Jiangsu Province 222100,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第12期2010-2014,共5页
Journal of Clinical Radiology
