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目的 探讨肝癌患者门脉受侵的螺旋CT经动脉门脉造影 (S -CTAP)及其门静脉三维重建图像的表现。方法 43例肝癌患者 ,其中原发性肝癌 2 7例 ,转移性肝癌 1 6例 ,均经肠系膜上动脉置管行S-CTAP。原始图像采用最大强度投影 (MIP)法行门静脉三维重建。结果 2 6例肝癌患者的门静脉不同程度受侵 ,S -CTAP轴位像表现为门脉腔内局限性低密度区 ,门脉分支受压、移位、阻断等 ,肝实质呈三角形或楔形低密度区 ,边缘呈“直线”征。MIP三维血管成像能显示门脉树的整体观 ,清楚显示 4～ 5级小分支 ,其形态改变更具体 ,更直观。结论 S -CTAP结合门静脉三维重建能清晰显示门脉受侵的形态改变 ,可以作为诊断肝癌患者门脉受侵的一种新技术
Objective To investigate the manifestation of S-CTAP and portal vein three-dimensional reconstruction of portal vein in patients with liver cancer. Methods Forty-three patients with liver cancer, including 27 cases of primary liver cancer and 16 cases of metastatic liver cancer, were treated with S-CTAP via superior mesenteric artery. The original image using maximum intensity projection (MIP) method three-dimensional portal vein reconstruction. Results The portal vein in 26 patients with HCC was invaded to varying degrees. The S -CTAP axial images showed localized low-density regions in the portal vein, pressure, displacement and blockage of the portal vessels. The liver parenchyma was triangular or wedge-shaped Low-density area, the edge was “straight” sign. MIP three-dimensional angiography can show the overall concept of portal vein tree, clearly shows 4 to 5 small branches, the morphological changes more specific and more intuitive. Conclusion S-CTAP combined with portal vein three-dimensional reconstruction can clearly show the morphological changes of portal vein invasion, which can be used as a new technique to diagnose the portal vein invasion in patients with liver cancer