• 1.長春市中心醫(yī)院介入科(長春 130051);;
  • 2.長春市中心醫(yī)院醫(yī)學(xué)影像科(長春 130051);;
  • 3.吉林大學(xué)第一臨床醫(yī)院介入科(長春 130021);

目的 探討多層螺旋CT門靜脈成像的臨床應(yīng)用價(jià)值。方法 應(yīng)用GE Light SpeedQX/i4 CT機(jī)對(duì)137例行CT增強(qiáng)掃描者的CT圖像進(jìn)行門靜脈成像，并分析其結(jié)果。137例中，肝癌46例，肝硬變20例，肝海綿狀血管瘤21例，肝膿腫9例，膽囊癌6例，膽管癌14例，胰腺癌16例，正常5例。結(jié)果 門靜脈期成功顯示門靜脈、腸系膜上靜脈及脾靜脈者109例，其中容積再現(xiàn)圖像顯示清晰者84例，最大密度投影及多平面重建圖像顯示清晰者109例。顯示門靜脈高壓45例，側(cè)支循環(huán)開放18例，門靜脈癌栓15例，單獨(dú)脾靜脈癌栓1例,巨大海綿狀血管瘤6例。結(jié)論 多層螺旋CT門靜脈成像能較清楚地顯示門靜脈解剖及其病變，為臨床醫(yī)生制定正確的治療方案提供依據(jù)。

引用本文： 孫鵬,賀永斌,李佳睿,王鑫淼,張柏秋,王大偉. 多層螺旋CT門靜脈成像在臨床中的應(yīng)用. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(12): 1318-1321. doi: 復(fù)制

1. 郭成偉, 梁文, 全顯躍, 等. 64層螺旋CT門靜脈三維成像變異分析及其在臨床中的應(yīng)用 [J]. 中國實(shí)用外科雜志, 2008; 28(8): 641-643.
2. Fischer L, Cardenas C, Thorn M, et al. Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis [J]. J Comput Assist Tomogr, 2002; 26(6): 962-967.
3. 薛彩霞. MSCT門靜脈重建技術(shù)的臨床應(yīng)用 [J]. 實(shí)用醫(yī)學(xué)影像雜志, 2006; 7(3): 189-191.
4. 朱康順, 李征然, 孟曉春, 等. 門靜脈高壓癥胃靜脈曲張的血流動(dòng)力學(xué)研究: 附22例直接門靜脈造影結(jié)果 [J]. 中國醫(yī)學(xué)影像技術(shù), 2006; 22(11): 1700-1703.
5. Kim HC, Kim TK, Sung KB, et al. CT during hepatic arteriography and portography: an illustrative review [J]. Radiographics, 2002; 22(5): 1041-1051.
6. Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications [J]. Radiographics, 2000; 20(6): 1787-1806.
7. Onodera Y, Omatsu T, Nakayama J, et al. Peripheral anatomic evaluation using 3D CT hepatic venography in donors: significance of peripheral venous visualization in living-donor liver transplantation [J]. AJR Am J Roentgenol, 2004; 183(4): 1065-1070.
8. Ichikawa T, Erturk SM, Araki T. Multiphasic contrast-enhanced multidetector-row CT of liver: contrast-enhancement theory and practical scan protocol with a combination of fixed injection duration and patients’ body-weight-tailored dose of contrast material [J]. Eur J Radiol, 2006; 58(2): 165-176.
9. Fishman EK. From the RSNA refresher courses: CT angiography: clinical applications in the abdomen [J]. Radiographics, 2001; 21: S3-S16.
10. 張志偉, 陳孝平, 胡道予, 等. 多排螺旋CT三維重建在肝臟外科中的應(yīng)用 [J]. 中國實(shí)用外科雜志, 2004; 24(11): 666-668.
11. Calhoun PS, Kuszyk BS, Heath DG, et al. Three-dimensional volume rendering of spiral CT data: theory and method [J]. Radiographics, 1999; 19(3): 745-764.
12. 路濤, 周翔平. 多層螺旋CT肝血管三維重建及臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(2): 233-236.
13. 董麗卿, 鄭祥武, 楊運(yùn)俊, 等. MSCT選擇性VR及其肝臟門脈系統(tǒng)成像 [J]. 中國醫(yī)學(xué)影像學(xué)雜志, 2007; 15(4): 266-269.
14. 李大慶, 舒圣捷, 高麗, 等. 64層螺旋CT門靜脈重建技術(shù)在肝癌合并癌栓的診斷價(jià)值 [J]. 哈爾濱醫(yī)科大學(xué)學(xué)報(bào), 2008; 42(4): 409-411.
15. 陳青華, 王洪波, 柳澄. 螺旋CT血管成像在腹部的應(yīng)用進(jìn)展 [J]. 國外醫(yī)學(xué)臨床放射學(xué)分冊(cè), 2005; 28(2): 78-82.
16. 史琲, 朱暉, 吳云林, 等. 門脈CTA及內(nèi)鏡對(duì)胃靜脈曲張?jiān)\斷及療效評(píng)估的比較研究 [J]. 胃腸病學(xué)和肝病學(xué)雜志, 2007; 16(6): 507-511.
17. Soyer P, Heath D, Bluemke DA, et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques [J]. J Comput Assist Tomogr, 1996; 20(1): 122-127.
18. 陳麗娜, 吳云林. 門靜脈CT血管造影在門靜脈高壓檢查中的臨床應(yīng)用 [J]. 診斷學(xué)理論與實(shí)踐, 2006; 5(3): 269-272.
19. 印隆林, 宋彬, 陳衛(wèi)霞, 等. 多排螺旋CT血管成像技術(shù)對(duì)門靜脈海綿樣變性側(cè)支血管的顯示 [J]. 中國普外基礎(chǔ)與臨床雜志, 2004; 11(6): 547-550.
20. Hopper KD, Iyriboz AT, Wise SW, et al. Mucosal detail at CT virtual reality: surface versus volume rendering [J]. Radiology, 2000; 214(2): 517-522.
21. Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices [J]. AJR Am J Roentgenol, 2001; 176(4): 899-905.
22. Chopra S, Dodd GD 3rd, Chintapalli KN, et al. Transjugular intrahepatic portosystemic shunt: accuracy of helical CT angiography in the detection of shunt abnormalities [J]. Radiology, 2000; 215(1): 115-122.
23. 李康, 呂富榮, 馬千紅, 等. 食管胃靜脈曲張供血與分流血管CT三維成像研究 [J]. 中國臨床解剖學(xué)雜志, 2009; 27(2): 184-186.
24. 靳勇, 林曉珠, 瞿晴, 等. 門靜脈CTA在門靜脈高壓門體分流側(cè)支血管顯示中的應(yīng)用 [J]. 臨床放射學(xué)雜志, 2008; 27(12): 1675-1679.
25. De Gaetano AM, Lafortune M, Patriquin H, et al. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography [J]. AJR Am J Roentgenol, 1995; 165(5): 1151-1155.
26. Song B, Min P, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels [J]. Abdom Imaging, 2000; 25(4): 385-393.
  1. 1. 郭成偉, 梁文, 全顯躍, 等. 64層螺旋CT門靜脈三維成像變異分析及其在臨床中的應(yīng)用 [J]. 中國實(shí)用外科雜志, 2008; 28(8): 641-643.
  2. 2. Fischer L, Cardenas C, Thorn M, et al. Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis [J]. J Comput Assist Tomogr, 2002; 26(6): 962-967.
  3. 3. 薛彩霞. MSCT門靜脈重建技術(shù)的臨床應(yīng)用 [J]. 實(shí)用醫(yī)學(xué)影像雜志, 2006; 7(3): 189-191.
  4. 4. 朱康順, 李征然, 孟曉春, 等. 門靜脈高壓癥胃靜脈曲張的血流動(dòng)力學(xué)研究: 附22例直接門靜脈造影結(jié)果 [J]. 中國醫(yī)學(xué)影像技術(shù), 2006; 22(11): 1700-1703.
  5. 5. Kim HC, Kim TK, Sung KB, et al. CT during hepatic arteriography and portography: an illustrative review [J]. Radiographics, 2002; 22(5): 1041-1051.
  6. 6. Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications [J]. Radiographics, 2000; 20(6): 1787-1806.
  7. 7. Onodera Y, Omatsu T, Nakayama J, et al. Peripheral anatomic evaluation using 3D CT hepatic venography in donors: significance of peripheral venous visualization in living-donor liver transplantation [J]. AJR Am J Roentgenol, 2004; 183(4): 1065-1070.
  8. 8. Ichikawa T, Erturk SM, Araki T. Multiphasic contrast-enhanced multidetector-row CT of liver: contrast-enhancement theory and practical scan protocol with a combination of fixed injection duration and patients’ body-weight-tailored dose of contrast material [J]. Eur J Radiol, 2006; 58(2): 165-176.
  9. 9. Fishman EK. From the RSNA refresher courses: CT angiography: clinical applications in the abdomen [J]. Radiographics, 2001; 21: S3-S16.
  10. 10. 張志偉, 陳孝平, 胡道予, 等. 多排螺旋CT三維重建在肝臟外科中的應(yīng)用 [J]. 中國實(shí)用外科雜志, 2004; 24(11): 666-668.
  11. 11. Calhoun PS, Kuszyk BS, Heath DG, et al. Three-dimensional volume rendering of spiral CT data: theory and method [J]. Radiographics, 1999; 19(3): 745-764.
  12. 12. 路濤, 周翔平. 多層螺旋CT肝血管三維重建及臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志, 2006; 13(2): 233-236.
  13. 13. 董麗卿, 鄭祥武, 楊運(yùn)俊, 等. MSCT選擇性VR及其肝臟門脈系統(tǒng)成像 [J]. 中國醫(yī)學(xué)影像學(xué)雜志, 2007; 15(4): 266-269.
  14. 14. 李大慶, 舒圣捷, 高麗, 等. 64層螺旋CT門靜脈重建技術(shù)在肝癌合并癌栓的診斷價(jià)值 [J]. 哈爾濱醫(yī)科大學(xué)學(xué)報(bào), 2008; 42(4): 409-411.
  15. 15. 陳青華, 王洪波, 柳澄. 螺旋CT血管成像在腹部的應(yīng)用進(jìn)展 [J]. 國外醫(yī)學(xué)臨床放射學(xué)分冊(cè), 2005; 28(2): 78-82.
  16. 16. 史琲, 朱暉, 吳云林, 等. 門脈CTA及內(nèi)鏡對(duì)胃靜脈曲張?jiān)\斷及療效評(píng)估的比較研究 [J]. 胃腸病學(xué)和肝病學(xué)雜志, 2007; 16(6): 507-511.
  17. 17. Soyer P, Heath D, Bluemke DA, et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques [J]. J Comput Assist Tomogr, 1996; 20(1): 122-127.
  18. 18. 陳麗娜, 吳云林. 門靜脈CT血管造影在門靜脈高壓檢查中的臨床應(yīng)用 [J]. 診斷學(xué)理論與實(shí)踐, 2006; 5(3): 269-272.
  19. 19. 印隆林, 宋彬, 陳衛(wèi)霞, 等. 多排螺旋CT血管成像技術(shù)對(duì)門靜脈海綿樣變性側(cè)支血管的顯示 [J]. 中國普外基礎(chǔ)與臨床雜志, 2004; 11(6): 547-550.
  20. 20. Hopper KD, Iyriboz AT, Wise SW, et al. Mucosal detail at CT virtual reality: surface versus volume rendering [J]. Radiology, 2000; 214(2): 517-522.
  21. 21. Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices [J]. AJR Am J Roentgenol, 2001; 176(4): 899-905.
  22. 22. Chopra S, Dodd GD 3rd, Chintapalli KN, et al. Transjugular intrahepatic portosystemic shunt: accuracy of helical CT angiography in the detection of shunt abnormalities [J]. Radiology, 2000; 215(1): 115-122.
  23. 23. 李康, 呂富榮, 馬千紅, 等. 食管胃靜脈曲張供血與分流血管CT三維成像研究 [J]. 中國臨床解剖學(xué)雜志, 2009; 27(2): 184-186.
  24. 24. 靳勇, 林曉珠, 瞿晴, 等. 門靜脈CTA在門靜脈高壓門體分流側(cè)支血管顯示中的應(yīng)用 [J]. 臨床放射學(xué)雜志, 2008; 27(12): 1675-1679.
  25. 25. De Gaetano AM, Lafortune M, Patriquin H, et al. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography [J]. AJR Am J Roentgenol, 1995; 165(5): 1151-1155.
  26. 26. Song B, Min P, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels [J]. Abdom Imaging, 2000; 25(4): 385-393.