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目的分析门静脉系统栓塞的部位分布特点,探讨其发病机制。方法收集经超声、磁共振(MRI)和数字减影血管成像(DSA)检查中至少一项诊断为门静脉系统栓塞的患者267例,所有病例均经CT平扫及增强扫描并与原诊断相符。其中恶性肿瘤组242例均经手术病理或活检证实,其余25例为非肿瘤组。比较所有病例肠系膜上静脉及脾静脉的受累情况,并比较恶性肿瘤组及非肿瘤组门静脉系统栓塞的累及范围。结果①与脾静脉受累程度(17/267,6.4%)相比,门静脉系统栓塞更易累及肠系膜上静脉(145/267,79.2%,P<0.05);分别将恶性肿瘤组及非肿瘤组中肠系膜上静脉及脾静脉受累的情况作比较,结果与前相同(P<0.05);②非肿瘤组中门静脉系统受累程度积分明显高于恶性肿瘤组(P<0.05)。结论门静脉系统栓塞与肠系膜静脉的功能、解剖及血流动力学特点密切相关;非肿瘤性门静脉系统栓塞较恶性肿瘤所致门静脉系统栓塞范围广泛。
Objective To analyze the location and distribution of portal embolism and to explore its pathogenesis. Methods Totally 267 patients diagnosed as portal vein embolism by ultrasonography, magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) were collected. All patients underwent CT plain scan and contrast-enhanced scan. Among them, 242 cases of malignant tumor group were confirmed by pathology or biopsy, and the remaining 25 cases were non-tumor group. The incidence of superior mesenteric vein and splenic vein in all cases was compared, and the embolization of portal vein in malignant and non-neoplastic groups was compared. Results ① Compared with the splenic vein involvement (17 / 267,6.4%), the portal vein embolization was more likely to involve the superior mesenteric vein (145 / 267,79.2%, P <0.05). The malignant and non-neoplastic mesentery (P <0.05). (2) The degree of portal vein involvement in the non-tumor group was significantly higher than that in the malignant tumor group (P <0.05). Conclusions The portal vein embolization is closely related to the function, anatomy and hemodynamics of mesenteric vein. The non-tumorous portal vein embolization is more extensive than that of malignant tumor.