肝脏移植术前受体64 排CT 血管成像临床应用价值

目的:探讨肝脏移植术前受体64排螺旋CT血管成像(computed tomography angiography CTA)在临床的应用价值。方法:对28例晚期肝病患者进行64排增强后动脉期、门脉期及静脉期扫描,使用多种重建方法,由两名以上有经验的医师对肝脏血管进行分析评价,并与18例移植术后结果比较,探讨64排CT血管成像对肝移植术前准备的意义。结果:发现肝动脉变异6例,腹腔干起始部狭窄2例,腹腔干动脉瘤1例,脾动脉瘤2例,肝脏主要供血动脉直径<3mm 3例,肝门静脉海绵样变3例,肝外门静脉主干栓塞5例,伴有肝内门静脉栓塞3例,肝外门静脉主干栓塞伴肠系膜上静脉广泛栓塞2例,下腔静脉癌栓3例,其中癌栓达右心房2例。结论:64排CT血管成像无创、可靠,通过多种重建方法,能清晰显示肝脏血管,对肝脏移植术前血管做出评价,具有可靠的临床指导意义。

Clinical Application Value of 64 Slice CT Angiography in LiverTransplantation Recipients

Objective: To investigate the Clinical application value of 64 slice CT angiography(64SCTA) in patients before surgery of liver transplantation.Methods: 28 cases with serious hepatopathy were evaluated by 64SCTA,Heaptic blood vessel were analysed by reformations of volum rendering(VR),maximum intensity projection(MIP)and Multi-plain(MPR).More than two experienced doctors made the diagnosis.Results: 6 cases with the hepatic artery variant,2 cases with celiac artery stenosis,1 case with celiac artery aneurysm,2 cases with splenic artery aneurysm,3 cases with the diameter of main hepatic supply artery no more than 3mm,3 cases with portal vein sponge degeneration,5 cases with portal vein embolism,2 cases with thrombosis in portal vein and superior mesenteric vein,3cases with vena cava embolism,2 cases with embolism near the right atrium.Cconclusion: Using all kinds of reconstructions to show hepatic vessel,64SCTA has significantly clinical value in liver transplantation.