Abstract
目的 探讨门静脉海绵样变性(CTPV)门脉胆支及胆系改变在MRI上的表现及其诊断价值.方法对18例行门体分流术的CTPV病人手术前后均行MR平扫、增强、门静脉动态对比增强MRA (dynamic contrast-enhanced magnetic resonance angiography, DCE-MRA)、MRCP检查,所有病例均经手术病理或DSA证实.结果 CTPV门脉胆支改变:18例CTPV病人门体分流术前MRI及DCE-MRA显示Petren胆囊周围静脉和胆总管外表面的Saint网状静脉丛17例,表现为迂曲扩张或呈结节状.分流术后显示胆囊周围静脉3例,Saint网状静脉丛2例.胆系改变:门体分流术前胆总管狭窄伴远端扩张6例、胆总管壁不规则5例、胆总管壁增厚4例、胆总管成角移位3例、胆囊壁增厚8例.分流术后胆系改变部分恢复.结论 MRI能准确检测CTPV病人门脉胆支及胆系的改变,早期正确判断门脉胆支及胆系的改变对胆系病变的鉴别诊断及临床采取正确的治疗措施具有重要意义。
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