首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (6): 732-736.

• 专题报道 • 上一篇    下一篇

肝泡状棘球蚴病门静脉血供的影像学研究

任伟新, 肖湘生   

  1. 中国人民解放军第二军医大学上海长征医院影像科
  • 收稿日期:2007-10-16 修回日期:1900-01-01 出版日期:2007-12-24 发布日期:2007-12-24

Imaging Study of Portal Vein Blood Supply in Hepatic Alveolar Echinococcosis

Ren Weixin, Xiao Xiangsheng   

  1. Department of Radiology, Shanghai Changzheng Hospital, Second Military Medical University
  • Received:2007-10-16 Revised:1900-01-01 Online:2007-12-24 Published:2007-12-24

摘要:

目的 应用多层螺旋CT造影(MSCTA)和间接门静脉数字减影血管造影(DSA)技术,对肝泡状棘球蚴病是否存在门静脉血供和门脉受累进行研究。方法 所有病例均行MSCTA和间接门静脉DSA检查。应用高级图像处理工作站,对MSCTA的资源影像行冠、矢状面重建和三维血管成像重建;选择肠系膜上动脉或脾动脉行间接门静脉DSA造影,显示门脉分支及病灶染色情况;对照分析影像学上的门静脉改变征象和手术结果。结果 MSCTA门脉期血管成像显示:门静脉受压移位8例、包绕10例、闭塞6例;尽管无1例在门静脉期呈现病灶明显增强,但有6例可见门静脉分支伸入到病灶内。间接门静脉DSA显示:门静脉受压移位6例、包绕11例、闭塞8例;门静脉期病灶呈环行染色3例、带状染色4例(43.8%,7/16),无病灶染色9例。与手术所见相比,MSCTA观察门静脉受累的敏感性88%、特异性81.8%、阳性预测值91.7%;DSA的敏感性93.9%、特异性88.9%、阳性预测值96.8%。结论 间接门静脉DSA显示门静脉可能参与肝泡状棘球蚴病的供血,MSCTA和间接门静脉DSA能够可靠地评价肝泡状棘球蚴病的门静脉受累情况。

关键词: 泡状棘球蚴病, 肝, 门静脉, 血供, CT, 造影

Abstract:

Objective To investigate the portal vein blood supply in hepatic alveolar echinococcosis(HAE) using multi-slice spiral CT angiography(MSCTA) and portal vein digital subtraction angiography(DSA).Methods Sixteen patients with HAE were scanned by MSCTA.The raw materials were transmitted to advanced workstation for image reconstruction.Then all of them underwent the indirect portal vein DSA.Correlative study of the portal vein involvement was shown and comparison between images(MSCT and DSA) and pathology performed.Results MSCTA showed that compression and displacement of portal vein occurred in 8 cases,encasement in 10 cases,and occlusion in 6 cases;and that there was no obvious enhancement of whole or marginal area of HAE at the portal vein stage in all patients.Indirect portal vein DSA revealed that compression and displacement of portal vein occurred in 6 cases,encasement in 11 cases,and occlusion in 8 cases;and that the circular stain of the lesion at the portal vein stage was observed in 3 cases,and belt stain in 4 cases(43.8%,7/16). Compared with surgical findings,the sensitivity,specificity and positive prediction value for the portal vein involvement was 88%,81.8%and 91.7%,respectively,for MSCTA;and 93.9%,88.9%and 96.8%,respectively,for indirect portal vein DSA.Conclusion There exists portal vein blood supply for hepatic alveolar echinococcosis confirmed by the indirect portal vein DSA.MSCT or indirect portal vein DSA is a reliable method to study the portal vein blood involvement in HAE.

Key words: alveolar echinococcosis, hepatic, portal vein, blood supply, computed tomography, angiography

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