层CT门脉成像和胃镜诊断胃静脉曲张的对比研究.docVIP

64层CT门脉成像和胃镜诊断胃静脉曲张的对比研究 李康1，2，吕富荣1，马千红2，杨庆军2，吕发金1，罗天友1（1．重庆医科大学附属第一医院放射科，重庆 400016；2．重庆市中山医院，重庆 400013） 【摘要】 目的 应用64层螺旋CT门静脉成像技术，观察不同类型胃静脉曲张(GV)的形态、程度、血供特点以及分流情况，并同胃镜下GV形态特点相比较，探讨64层螺旋CT门静脉成像在GV诊断中的价值。方法 收集我院64层螺旋CT门静脉成像并经胃镜检查证实的胃静脉曲张(GV)病例35例。采用64层螺旋CT扫描，扫描范围从膈上1cm至髂骨翼上缘水平。先常规平扫，后三期增强扫描，再进行三维重建，重建方法采用MIP、VR、MPR，重点观察曲张胃底静脉的形态、程度、供血血管以及有无脾/胃-肾静脉分流等。结果 本组35例，64层螺旋CT门静脉成像(CTPV)检出胃静脉曲张(GV)35例，胃镜检出34例，符合率97.1%。CTPV与胃镜在显示GV形态方面一致性较好。GOV-1型以LGV供血多见；GOV-2型全是LGV+PGV+SGV供血；IGV型以SGV+PGV供血为主。GOV-1型胃/脾-肾分流发生率为15.8%；GOV-2型分流发生率为50%；IGV型分流发生率为62.5%。结论 64层螺旋CT门静脉成像可无创显示GV，在显示GV形态方面，与胃镜有很好的一致性，还能很好地显示GV的供血及分流血管。64层螺旋CT门静脉成像是诊断胃底静脉曲张的有效检查方法。 关键词：64层螺旋CT；门静脉成像；胃静脉曲张；侧支循环 中图法分类号：R814.42；R575.2 文献标识码：A comparison between 64 channel multidector row CT venography and gastroscope in the diagnosis of gastric varices LI Kang1，2, LU Fu-rong1, MA Qian-hong2, YANG Qing-jun2, LU Fa-jin1 LUO Tian-you1 (1．Department of Radiology, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China. 2．Department of Radiology, Chongqing 作者介绍：李 康，男，重庆永川人，硕士，副主任医师，工作单位重庆市中山医院， 主要从事体部影像诊断方面的研究。电话likangdoctor?likangdoctor@126.com 通讯作者：吕富荣，E-mail:lfr918@，电话zhongshan Hospital, Chongqing 400013 ,China．) 【Abstract】 Objective To observe the morphous, degree, features about blood supply and shunt status in different types of gastric varices, compare with those by gastroscope, and discuss the value of CT portal venography in the diagnose of gastric varices. Methods 35 cases with 64 channel multidector row CT venography verified by gastroscope in our hospital were selected. 64 channel multidector row CT scanner(GE, Lightspeed VCT) was employed, scan range was from 1 cm above diaphragm to the superior border of iliac ala. Plain scanning was first carried out, following with enhancement scanning of three phrases and postprocessing with the reconstruction techniques of volume rendering(VR), maximum intensity projection(MIP), multi-planar reconstruct