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目的通过64层螺旋CT(64-MSCT)对非肝病患者及肝硬化Child-Pugh A、B分级组患者门静脉右支1、2cm处与肝中静脉、肝右静脉1、2、3cm间模拟穿刺途径进行测量。方法选取上腹部64-MSCT扫描非肝病被检查组共40例;肝硬化组符合纳入标准14例。用智能追踪技术启动扫描,在GEADW4.2工作站进行处理。结果正常组与肝硬化Child-Pugh A、B分级组ФMHV1、ФRHV1有统计学差异(P<0.05)。正常组肝右静脉1～2cm处及肝中静脉1～2cm处直径较肝硬化Child-Pugh A、B分级组减小迅速。正常组与肝硬化Child-Pugh A、B分级组模拟穿刺途径距离DMHV2-RPV1、DMHV3-RPV1、DMHV3-RPV2、DRHV1-RPV1间有统计学差异(P<0.05)。结论64-MSCT及三维重建技术是准确测量活体功能状态下肝内血管的有效方法。肝内门腔分流术模拟穿刺途径的研究有助于选择适当长度和类型的支架。
Objective To evaluate the clinical value of 64-slice spiral CT (64-MSCT) in the diagnosis of non-liver disease and Child-Pugh A and B cirrhosis patients at 1, 2 cm of right portal vein and middle and middle hepatic vein, Way to measure. Methods Forty-four cases of non-liver disease were scanned by 64-MSCT in the upper abdomen. Forty patients with cirrhosis were included in the study. Start scanning with smart tracking technology and work on GEADW4.2 workstations. Results There was a significant difference between normal group and Child-Pugh A and B grade group (ФMHV1 and ФRHV1) (P <0.05). The diameter of the normal right hepatic vein in 1 ~ 2cm and the middle hepatic vein in 1 ~ 2cm diameter was smaller than that of Child-Pugh A and B in cirrhosis. There was a significant difference (P <0.05) between DMHV2-RPV1, DMHV3-RPV1, DMHV3-RPV2 and DRHV1-RPV1 in Child-Pugh class A and B cirrhosis grading group. Conclusion 64-MSCT and three-dimensional reconstruction is an effective method to accurately measure intrahepatic vessels in vivo. Intrahepatic portosystemic shunt simulation of the puncture pathway helps to select the appropriate length and type of stent.