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目的探讨门脉高压症患者心膈角静脉曲张的发生率、MSCT表现及临床意义。方法回顾性分析140例门脉高压症患者的MSCT图像,利用MPR、MIP及VRT技术对心膈角区结节状或(和)管状影进行分析并测量。结果140例门脉高压症患者中有44例(31.4%)心膈角静脉曲张,以右前心膈角为多见;MSCT表现为心膈角区结节样和(或)管状软组织密度影,边界清楚,体积较小,曲张静脉直径为3.5~14.0mm,平均6.7mm;三期动态增强扫描曲张静脉从动脉期到静脉期逐渐增强,CT值与同层静脉血管(如食管胃底曲张静脉)大致相同;MPR、MIP及VRT技术可显示大多数(73%)心膈角区结节状或(和)管状影与心包膈静脉、膈肌静脉密切相关。结论心膈角静脉曲张在门脉高压症患者中并不少见,MSCT可以对其进行良好的显示,对心膈角静脉曲张的诊断及鉴别诊断具有重要的临床意义。
Objective To investigate the incidence of diaphragmatic varicocele in patients with portal hypertension and its clinical significance. Methods The MSCT images of 140 patients with portal hypertension were retrospectively analyzed. The MPR, MIP and VRT techniques were used to analyze and measure the nodular or (or) tubular shadow in the diaphragmatic area. Results Of the 140 patients with portal hypertension, 44 cases (31.4%) of the patients had diaphragmatic varicose veins, which were more common in the right anterior phrenic angle. MSCT showed nodular and / or tubular soft tissue density in the diaphragmatic region, Clear border, smaller volume, varicose vein diameter of 3.5 ~ 14.0mm, an average of 6.7mm; three dynamic enhanced scanning varicose vein gradually increased from the arterial phase to the venous phase, CT values and venous blood vessels (such as esophageal varices ). The MPR, MIP and VRT techniques showed that most (73%) of the phrenic nodules or (and) tubular shadow were closely related to the phrenic veins and diaphragmatic veins of the pericardium. Conclusions Diaphragmatic varicose veins are not uncommon in patients with portal hypertension. MSCT can display them well and has important clinical significance in the diagnosis and differential diagnosis of phrenic varicose veins.