目的探讨多层螺旋CT门静脉成 像（CTPV）对门静脉高压症（PHT）的诊 断及分类价值。方法 收集42例PHT,肝内 性PHT 26例,均为肝硬化患者,合并肝癌7 例,门静脉肝内分支癌栓形成3例；肝前性 PHT13例,其中门静脉肝外段血栓3例,门静 脉肝外段癌栓4例,海绵样变6例；肝后性 PHT3例,为布加综合征患者；均行64层螺 旋CT门静脉成像检查,容积数据采用MIP、 VR、MPR或CPR重建,观察门静脉、属支及 侧支循环的影像学特征。结果 CTPV能清 楚显示侧支循环的分布范围、初步评估门 静脉高压程度及部位分类。结论 CTPV能 准确诊断PHT及鉴别分类,对预测其并发 症、手术方案的制定具有重要的指导意 义。

Objective Discussion on classification and diagnostic value of multi-slice spiral CT portography (CTPV) on portal hypertension (PHT). Methods A total of 42 patients with PHT, 26 cases of intrahepatic PHT, both in patients with liver cirrhosis, and hepatocellular carcinoma in 7 cases,3 cases of intrahepatic portal vein tumor thrombosis; before the liver of PHT13patients, including 3 cases of portal vein thro mbosis in 4 cases of outer segment, portal vein tumor thrombus in 6 cases of outer segment,cavernous transformation, liver after PHT Budd Chiari syndrome in 3 cases; underwent imaging of 64 slice spiral CT portal, MIP, VR,MPR or CPR reconstruction using volume data, observation of portal vein branches, collateral circulation, characteristics of imaging. Results CTPV can clearly show the initial distribution, evaluating collateral circulation of portal hypertension degree and position classification. Conclusion CTPV can accurately diagnose PHT and differential classification, have important significance to establish prediction of its complications, operation scheme.