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目的:应用64层螺旋CT肝门静脉成像(CTPV)技术,探讨食管胃静脉曲张供血血管与分流血管解剖特征。方法:收集并分析我院64层螺旋CT肝门静脉成像及胃镜检查证实的食管胃静脉曲张50例。先常规平扫,后三期增强扫描,三维重建方法采用MIP、VR、MPR。结果:本组50例,食管静脉曲张几乎全部由胃左静脉供血,单纯由胃左静脉前支供血57.8%(26例),伴有食管旁静脉曲张82.2%(37例);胃底静脉曲张由单纯胃左静脉供血61.1%(22例),由胃短、胃后静脉供血11.1%(4例),由胃短、胃后、胃左静脉双重供血27.8%(10例)。脾/胃-肾静脉分流20%(10例)。结论:64层螺旋CT肝门静脉成像能立体、清晰地显示食管胃静脉曲张的供血与分流血管,对临床选择治疗方案具有重要价值。
Objective: To evaluate the anatomic characteristics of blood vessels and shunt vessels in esophageal and gastric varices by using 64-slice spiral CT hepatic portal vein imaging (CTPV). Methods: Fifty cases of esophagogastric varices confirmed by 64-slice spiral CT hepatic portal vein imaging and gastroscopy in our hospital were collected and analyzed. First conventional plain scan, the latter three enhanced scan, three-dimensional reconstruction method using MIP, VR, MPR. Results: In this group of 50 patients, almost all of the esophageal varices were supplied by the left gastric vein, 57.8% (26 cases) of gastric anastomosis alone, 82.2% (37 cases) of esophageal varices, gastric varices 61.1% (22 cases) of simple gastric left venous blood supply from the stomach, 11.1% (4 cases) from the gastric venous blood supply, and 27.8% (10 cases) double supply of blood from the stomach, stomach and left gastric vein. Spleen / stomach - renal vein shunt 20% (10 cases). Conclusion: 64-slice spiral CT hepatic portal vein imaging can display the blood supply and shunt of esophagogastric varices in three dimensions, which is of great value for clinical choice of treatment.