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目的用多层螺旋CT(MSCT)统计、分析肝硬化门静脉高压患者的侧枝循环表现。方法收集203例肝硬化门静脉高压患者MSCT上腹部检查的完整资料。结果共发现门静脉侧枝或异常血管612处:食管下段静脉曲张175处,食管旁静脉曲张49处(其中伴假肿瘤征13处),胃底静脉曲张119处,胃冠状静脉曲张105处,胃肾静脉分流34处,脾肾静脉分流15处,椎旁静脉丛曲张16处,脐静脉再通48处,副脐静脉再通22处,脐静脉、副脐静脉同时再通4处,腹壁静脉丛曲张呈蛇头征12处,门静脉海绵样变8处,门静脉右后支瘤样扩张并与下腔静脉分流4处,胃左静脉直接入肝与门静脉左支相连1处。结论MSCT可较好地显示各类门静脉高压侧枝,了解这些异常表现有助于作出正确诊断,避免误诊,对临床选择治疗方法有重要的意义。
Objective To evaluate the collateral circulation in cirrhotic patients with portal hypertension by multislice spiral CT (MSCT). Methods The complete data of 203 MSCT upper abdominal examinations of patients with cirrhosis and portal hypertension were collected. Results A total of 612 portal venous branches or abnormal blood vessels were found in the study: 175 esophageal varices, 49 esophageal varices, 13 esophageal varices, 119 gastric varices, 105 gastric varices, Venous shunt 34, 15 splenic and renal shunt, paravertebral venous plexus 16, recanalization of 48 umbilical cord, umbilical vein recanalization of 22, umbilical vein, vice umbilical vein at the same time through 4, abdominal venous plexus Qu Zhang showed snakehead sign 12, portal vein sponge-like change 8, portal vein right posterior branch tumor-like expansion and inferior vena cava shunt 4, the left gastric venous liver directly connected with the left portal vein 1. Conclusion MSCT can display various types of portal hypertension, and understanding these abnormalities can help to make correct diagnosis and avoid misdiagnosis. It is of great significance for clinical choice of treatment.