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1、实用医学影像杂志2010年第11卷第1期JPMI，2010，Vol.11,No.1·021··论著·三维动态增强MR血管成像对门静脉海绵样变性的诊断徐成,杜崇禧,贺业新,李军东,胡彦君(山西省人民医院磁共振室,山西太原030012)【摘要】目的分析门静脉海绵样变性(CTPV)在三维动态增强磁共振血管成像（3D-DCEMRA）上的表现和特征,并评价其诊断价值。方法回顾性分析了经临床及DSA检查证实的11例门静脉海绵样变性的3D-DCEMRA的特征性表现。结果本组11例CTPV中，门静脉主干闭塞见于6例,门静脉主干及左右支均
2、受累者3例,单纯左支或右支闭塞2例。9例3D-DCEMRA清楚地显示了数条迂曲的侧支循环静脉跨过阻塞部位向肝内匐形延伸,其中7例可在网状扩张的门静脉腔内显示细条状、小点状低信号血栓影,6例清楚地显示门静脉全程多条细小迂曲的侧支循环静脉缠绕在一起,扭曲成网状的血管结构。结论3D-DCEMRA能准确地提供CTPV的位置、严重程度等信息,可直观地评价本病,为临床采取正确的治疗措施提供可靠依据。【关键词】门静脉;海绵样变性；磁共振;血管成像【中图分类号】R445.2；R575.2+9【文献标识码】A【文章编号】1009-6817
3、（2010）01-0021-03Diagnosticvalueof3D-DCEMRAforcavernoustransformationofportalveinXuCheng,DuChongxi,HeYexin,LiJundong,HuYanjun.MRDivision,ShanxiProvincialPeople'sHospital,Taiyuanshi030012,China【Abstract】ObjectiveToanalyzethree-dimensionaldynamiccontrast-enhancedmag
4、neticresonanceangiography(3D-DCEMRA)featuresofcavernoustransformationofportalvein(CTPV)andtoassesstheirvalueforthediagnosis.MethodsElevenpatientswithclinicallyandDSAprovedCTPVunderwent3D-DCEMRAexaminations,subsequently,theimagingfindingsofallthepatientswereanalyz
5、edretrospectively.ResultsAmong11CTPVpatients,themaintrunkocclusionsofportalvenoussystemwerefoundin6,theinvolvementofmaintrunkandleftorrightbranchesin3,andthesimplexocclusionsofleftorrightbranchesin2.3D-DCEMRAclearlyshowedseveralcircuitouscollateralveinstridingove
6、robstructionandserpiginouslyextendingintotheliverin9cases，ofwhom,7casewerefoundtohavethinstreakyorsmallpunctualshadowswithhypointensitysuggestingthrombiinnet-likedilatedportalvenouscavities.Simultaneously3D-DCEMRAclearlyshowedmultiplecircuitouscollateralveinstran
7、glingtogetherandkinking-coilingintonet-likevascularstructuresin6cases.Conclusion3D-DCEMRAcanaccuratelyprovidetheinformationaboutthesiteandseverityofCTPVanddirectlyevaluatethisdiseassothatitcanprovidethereliableevidenceforplanningproperlytherapeuticprotocol.【Keywo
8、rds】Portalvein;Cavernoustransformation;Magneticresonance;Angiography门静脉海绵样变性(CTPV)是指门静脉主干或MRA检查。其中男7例,女4例,年龄25～56岁,所其分支完全或部分阻塞后,其周围形成大量侧支血有患者均经手术病理或DSA证实。MR成像采
