摘要
目的：利用256层螺旋CT对肝泡性包虫切除前后肝门静脉进行成像，进而对手术前后门脉情况进行评估。方法：回顾性分析行肝脏CT检查确诊为肝泡性包虫病患者20例，CT显示病灶均累及肝脏3段及以上，门脉左右支或主干受不同程度侵犯，20例患者均行部分肝叶切除术，术后14～20d内行肝脏CT复查，选择肝脏三期增强中门脉期进行观察评价，以比较手术前后门脉差异，对其门脉管径进行测量，判断患者术后门脉情况及有无相应并发症等。结果：20例手术患者中，术前门脉左支受侵5例，右支受侵12例，左右支均受侵3例；其中患者门脉主干受压明显12例，患者门脉轻度受压8例；术后MSCT图像显示，20例患者门脉受压均得到相应好转，门脉造影剂充盈良好；管径测量结果显示，所有患者门脉术后较术前均不同程度增宽，基本恢复至正常水平。结论：多层螺旋CT不仅可对肝包虫病术前门脉受侵情况作出评估，为手术制定提供依据，并且能对切除术后残余肝内门脉的恢复情况提供详细的影像学判断。
Objective:Using 256 slice spiral CT for hepatic alveolar echinococcosis hepatic portal vein imaging before and after resection,then to evaluate the situation of portal vein before and after the operation.Methods:We made a retrospective analysis of 20 patients with hepatic alveolar echinococcosis examined by liver CT examination.CT showed that the lesions were involved in 3 segments of the liver and above,the left and right branches or trunk of the portal vein were violated in different degrees,partial hepatectomy was performed in 20 patients,after 14～20 days performed the liver CT examination,we selected the portal phase of three period enhancement in liver to observe and evaluate,in order to compare the difference of portal vein before and after operation,measuring the diameter of the portal vein to judge the portal vein of patient and whether corresponding complications exist.Results:In 20 cases of patients before the surgery,5 patients with the left branch involved,12 patients with the right branch involved,3 patients with the both branches involved,in which 12 cases of patients with portal vein compression significantly,8 cases of patients with mild portal compression.The MSCT images showed after surgery that 20 cases of patients with portal pressure were improved,and the contrast agent filling well.The diameter measurement results showed that all patients’portal vein were broadening in different degrees,restored to normal level.Conclusion:Multi slice spiral CT can not only evaluate the preoperative portal vein in alveolar echinococcosis disease,providing operational information,but also can provide detailed imaging judgment on the recovery of residual liver portal vein after resection.
作者
韩淼
鲍海华
Han Miao;Bao Haihua(Department of Imaging Center,Affiliated Hospital of Qinghai University 810001)
出处
《中国社区医师》
2016年第25期139-140,143,共3页
Chinese Community Doctors
关键词
256层螺旋CT
泡性包虫
门静脉
256 slice spiral CT
Alveolar echinococcosis
The portal vein
