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目的探讨门静脉CT血管成像(PVCTA)在诊断门静脉瘤(portal vein aneurysm,PVA)中的价值。资料与方法回顾性分析3例PVA的临床与CTA资料,并复习相关文献。结果PVCTA清晰显示3例PVA的发生部位、扩张程度及与邻近结构的解剖学关系。3例均位于肝门或肝内门静脉分支交汇处,2例病变呈囊状,1例病变局部一致性扩张。3例均无相应临床表现及基础病变。文献报道18例中13例位于肝内门静脉分支交汇处,4例位于脾静脉与肠系膜上静脉交汇处,1例位于门静脉主干。18例中5例有肝癌伴肝硬化,其余无临床表现(6例)或仅有腹痛或腹部不适(7例)。结论PVA好发于肝内或肝外门静脉交汇处,多无基础疾病,PVCTA能够清楚显示PVA的部位、大小、形态、有无血栓、瘤体与邻近结构的空间关系。
Objective To explore the value of portal venous CT angiography (PVCTA) in the diagnosis of portal vein aneurysm (PVA). Materials and Methods Retrospective analysis of 3 cases of PVA clinical and CTA data, and review the relevant literature. Results PVCTA clearly shows the location of 3 cases of PVA, the degree of expansion and the anatomical relationship with the adjacent structures. All the 3 cases were located at the junction of hepatic portal or intrahepatic portal vein, 2 cases were cystic and 1 case was local concomitant expansion. None of the 3 cases had corresponding clinical manifestations and underlying lesions. Reported in the literature in 13 cases of 13 cases located in the junction of the hepatic portal vein, 4 cases located in the spleen vein and superior mesenteric vein junction, 1 case located in the main portal vein. Five of the 18 patients had hepatocellular carcinoma with cirrhosis and the remaining had no clinical manifestation (n = 6) or only abdominal pain or abdominal discomfort (n = 7). Conclusions PVA is more likely to occur in the intrahepatic or extrahepatic portosystemic junction with more underlying diseases. PVCTA can clearly show the location, size, shape, presence or absence of thrombus and the spatial relationship between the tumor and adjacent structures.