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目的用多层螺旋CT进行门静脉CT血管造影(CTA)成像,了解门静脉高压症的病因,周围侧支血管及胃左肾静脉分流道的情况,为临床合理选择治疗方法提供影像学依据。方法对32例怀疑有门静脉高压的患者进行门脉CTA检查,分别行动脉期和门脉期双期CT扫描和重建。结果32例患者中有27例存在门脉高压,胃底、食道静脉曲张。其中4例为胰腺炎后上消化道出血患者,出血的原因是胰腺炎所致脾静脉中断,造成胃底静脉曲张出血;3例为肝内门脉海绵样变性;9例为门脉高压伴胃底-左肾静脉分流道;11例为单纯肝硬化、门脉高压。结论门脉CTA是门脉高压、食道和胃底静脉曲张患者的重要检查手段,可以明确发现食道、胃底静脉曲张的范围、程度及变异,并可发现非肝硬化性门脉高压的病因。
Objective To evaluate the etiology of portal hypertension and portal vein CT angiography (CTA) with multi-slice spiral CT, and to understand the etiology of portal hypertension and the circumferences of collateral vessels and gastric left renal vein shunt, so as to provide imaging basis for clinical reasonable choice of treatment. Methods Thirty-two patients with suspected portal hypertension were examined by portal CTA. Two-phase CT scan and reconstruction of the arterial and portal venous phases were performed. Results Thirty-two of 32 patients had portal hypertension, gastric fundus and esophageal varices. 4 cases of pancreatitis after upper gastrointestinal bleeding in patients with bleeding due to pancreatic splenic vein disruption caused by gastric varices bleeding; 3 cases of hepatic portal degeneration sponge-like; 9 cases of portal hypertension Stomach - left renal vein shunt; 11 cases of simple cirrhosis, portal hypertension. Conclusions Portal venous CTA is an important method for detecting portal hypertension, esophageal and gastric varices. The range, extent and variation of esophageal and gastric varices can be clearly found, and the etiology of non-cirrhotic portal hypertension can be found.