遗传性出血性毛细血管扩张症多排螺旋CT影像特征分析
发布时间：2018-11-14 08:38
【摘要】：目的总结遗传性出血性毛细血管扩张症(hereditary hemorrhagic telangieetasia,HHT)患者多排螺旋CT(multi-detector helical computed tomography,MDCT)的影像学特征。方法回顾性分析14例HHT患者的MDCT影像特征,所有病例均行容积再现(VR)、最大密度投影(MIP)及多平面重建(MPR)。结果 14例患者中,肺部受累5例,CT轴位显示结节状或团块状强化灶,VR及MIP显示瘤体及供血动脉和引流静脉。肝脏受累12例,包括肝动脉-肝静脉分流6例,肝动脉-门静脉分流2例,门静脉-肝静脉分流4例。肝动脉-肝静脉分流:轴位动脉期可见肝门增粗、迂曲的血管影,肝静脉提前显影,MIP及VR显示肝动脉及其分支迂曲扩张;肝动脉-门静脉分流:MIP及MPR肝动脉和门静脉同时显影,MPR同时显示肝内多发斑片状异常强化区;门静脉-肝静脉分流:门静脉期MPR及MIP可见门静脉与肝静脉分支间迂曲扩张的交通血管及斑片状强化区。胰腺受累5例,动脉期MPR及MIP显示胰头周围扩张的血管团2例及瘤样扩张1例,胰头或胰尾部结节状异常强化灶2例。脾脏受累1例,动脉期MPR表现为脾脏内多发斑片状异常强化灶及脾动脉瘤形成。小肠受累1例,VR及MIP显示为肠系膜上静脉分支远端迂曲的血管团。结论 HHT累及多脏器的影像表现具有特异性,CT血管重建能够清晰显示HHT的血管变异,MDCT有助于临床诊断。
[Abstract]:Objective to summarize the imaging features of multiple helix CT (multi-detector helical computed tomography,MDCT) in patients with hereditary hemorrhagic telangiectasia (hereditary hemorrhagic telangieetasia,HHT). Methods the MDCT imaging features of 14 patients with HHT were retrospectively analyzed. All patients underwent volume reconstruction (VR), maximum density projection (MIP) and multiplanar reconstruction (MPR). Results in 14 cases, pulmonary involvement was found in 5 cases. CT showed nodular or mass enhancement on axis, and VR and MIP showed tumor and supplying artery and drainage vein. There were 12 cases of hepatic involvement, including 6 cases of hepatic arterial-hepatic shunt, 2 cases of hepatic arterial-portal shunt and 4 cases of portal-hepatic vein shunt. Hepatic arterial-hepatic vein shunt: hepatic porta was thickened and tortuous vessels were seen in axial phase, hepatic vein was developed ahead of time, MIP and VR showed hepatic artery and its branches tortuous dilatation. Hepatic arterial-portal shunt: MIP and MPR showed hepatic artery and portal vein at the same time, and MPR showed multiple patchy enhancement areas in liver simultaneously. Portal-hepatic shunt: MPR and MIP in portal vein phase showed tortuous dilated communicating vessels and patchy enhancement area between portal vein and hepatic vein branches. There were 5 cases of pancreatic involvement, 2 cases of vasodilation around the head of pancreas, 1 case of tumor-like dilatation, 2 cases of nodular enhancement of pancreatic head or tail, and 2 cases of abnormal enhancement of pancreatic head or tail on MPR and MIP. Splenic involvement occurred in 1 case, and MPR showed multiple plaque enhancement and splenic aneurysm formation. The small intestine was involved in one case. VR and MIP showed that the superior mesenteric vein branch was a convoluted vessel mass at the distal end. Conclusion the imaging features of HHT involving multiple organs are specific. The vascular remodeling of CT can clearly show the vascular variation of HHT. MDCT is helpful for clinical diagnosis.
【作者单位】： 首都医科大学附属北京佑安医院放射科;郑州市第六人民医院放射科;
【分类号】：R543;R816.2
，
本文编号：2330677
[Abstract]:Objective to summarize the imaging features of multiple helix CT (multi-detector helical computed tomography,MDCT) in patients with hereditary hemorrhagic telangiectasia (hereditary hemorrhagic telangieetasia,HHT). Methods the MDCT imaging features of 14 patients with HHT were retrospectively analyzed. All patients underwent volume reconstruction (VR), maximum density projection (MIP) and multiplanar reconstruction (MPR). Results in 14 cases, pulmonary involvement was found in 5 cases. CT showed nodular or mass enhancement on axis, and VR and MIP showed tumor and supplying artery and drainage vein. There were 12 cases of hepatic involvement, including 6 cases of hepatic arterial-hepatic shunt, 2 cases of hepatic arterial-portal shunt and 4 cases of portal-hepatic vein shunt. Hepatic arterial-hepatic vein shunt: hepatic porta was thickened and tortuous vessels were seen in axial phase, hepatic vein was developed ahead of time, MIP and VR showed hepatic artery and its branches tortuous dilatation. Hepatic arterial-portal shunt: MIP and MPR showed hepatic artery and portal vein at the same time, and MPR showed multiple patchy enhancement areas in liver simultaneously. Portal-hepatic shunt: MPR and MIP in portal vein phase showed tortuous dilated communicating vessels and patchy enhancement area between portal vein and hepatic vein branches. There were 5 cases of pancreatic involvement, 2 cases of vasodilation around the head of pancreas, 1 case of tumor-like dilatation, 2 cases of nodular enhancement of pancreatic head or tail, and 2 cases of abnormal enhancement of pancreatic head or tail on MPR and MIP. Splenic involvement occurred in 1 case, and MPR showed multiple plaque enhancement and splenic aneurysm formation. The small intestine was involved in one case. VR and MIP showed that the superior mesenteric vein branch was a convoluted vessel mass at the distal end. Conclusion the imaging features of HHT involving multiple organs are specific. The vascular remodeling of CT can clearly show the vascular variation of HHT. MDCT is helpful for clinical diagnosis.
【作者单位】： 首都医科大学附属北京佑安医院放射科;郑州市第六人民医院放射科;
【分类号】：R543;R816.2
，
本文编号：2330677
本文链接：https://www.wllwen.com/yixuelunwen/yundongyixue/2330677.html
最近更新
教材专著
