多层螺旋CT及其门静脉造影在TIPS联合胃冠状静脉栓塞术前应用价值

发布时间：2018-05-02 10:50

本文选题：肝硬化 + 颈静脉肝内门体分流术　；参考：《介入放射学杂志》2015年06期

【摘要】：目的探讨多层螺旋CT(MSCT)及多层螺旋CT门静脉造影(MSCTP)在经颈静脉肝内门体分流(TIPS)联合胃冠状静脉栓塞(GCVE)术前应用的价值。方法对126例肝硬化门静脉高压伴发食管胃底静脉曲张破裂出血或顽固性腹水拟行TIPS联合GCVE患者,术前行MSCT及MSCTP检查。采用最大密度投影(MIP)、多平面重组(MPR)、遮蔽表面显示(SSD)和容积再现(VR)等后处理技术全面了解肝脏情况。结果 MSCT及MSCTP能清晰显示肝硬化肝脏形态变化、肝静脉与门静脉空间位置关系、门静脉侧支循环开放程度和范围以及腹水等情况,为TIPS联合GCVE术前评估提供了重要的解剖信息。结论 MSCT及MSCTP是无创性检查并明确诊断肝硬化门脉高压症的可靠方法,对TIPS联合GCVE术中准确引导门静脉穿刺及曲张静脉栓塞治疗具有重要指导意义。
[Abstract]:Objective to evaluate the value of MSCT and MSCTP in the treatment of intrahepatic portosystemic shunt (TIPS) combined with gastric coronary vein embolization (GCVEE). Methods 126 patients with portal hypertension associated with esophageal and gastric varices bleeding or intractable ascites were treated with TIPS combined with GCVE. MSCT and MSCTP were performed before operation. Post-processing techniques such as maximum density projection (MIP), multiplanar recombination (MPRP), shaded surface display (SSD) and volumetric reproducing (VRV) were used to understand the liver condition. Results MSCT and MSCTP could clearly show the changes of liver morphology, the spatial relationship between hepatic vein and portal vein, the opening degree and scope of collateral circulation of portal vein and ascites, which provided important anatomical information for preoperative evaluation of TIPS combined with GCVE. Conclusion MSCT and MSCTP are noninvasive and reliable methods for diagnosis of portal hypertension in cirrhotic patients. It is of great significance to guide portal vein puncture and varicose vein embolization during TIPS combined with GCVE.
【作者单位】：昆明医科大学第二附属医院介入放射科;
【基金】：云南省卫生科技项目(2012WS0107) 云南省卫生科技计划项目(2014NS112)
【分类号】：R575.2;R816.5

【参考文献】