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