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目的探讨肝内门-体静脉分流(intrahepatic portosystemic venous shunts,IPSVS)多层螺旋CT(MSCT)的表现及其诊断价值。资料与方法从3360例接受MSCT动态增强检查并行多平面重组(MPR)、曲面重组(CPR)及容积再现(VR)等后处理的患者资料中,选出7例IPSVS病例,回顾性分析其MSCT表现。结果7例中6例伴有肝硬化、门静脉高压,在MSCT像上均出现门静脉右后支增粗,并沿肝裸区迂曲走行,最终汇入下腔静脉,在CPR及VR图像上显示更加逼真。1例无肝脏基础病的IPSVS,其MSCT图像显示门静脉右后支与肝右静脉间形成动脉瘤样通路,其彩色多普勒血流显像(CDFI)和VR图像清晰地显示了分流血管的情况。结论采用MSCT的二维MPR、CPR和三维VR等后处理技术,能清晰、逼真地显示IPSVS血管全程走行及分流道局部情况,可作为IPSVS的主要诊断手段。
Objective To investigate the performance and diagnostic value of intrahepatic portosystemic venous shunts (MSVVS) multi-slice spiral CT (MSCT). Materials and Methods Seven patients with IPSVS were selected from 3360 patients who underwent MSCT dynamic contrast-enhanced multi-planar reconstruction (MPR), surface reconstruction (CPR) and volume rendering (VR) postprocessing. The data of MSCT which performed. Results Six of the seven patients had cirrhosis and portal hypertension. The right posterior branch of the portal vein appeared thickening on the MSCT images and tortuous along the liver parenchyma. Finally, they were introduced into the inferior vena cava and displayed more on CPR and VR images lifelike. One case of IPSVS with no underlying liver disease showed MSCT images of aneurysm-like pathways between the right posterior branch of the portal vein and the right hepatic vein, and its color Doppler flow imaging (CDFI) and VR images clearly showed that the shunt vessels Happening. Conclusions MSCT 2D MPR, CPR and 3D VR postprocessing techniques can clearly and vividly show the local travel of the IPSVS blood vessels and the local conditions of the shunt, which can be used as the main diagnostic tool of IPSVS.