Hepatofugal Collaterals in Advanced Liver Cirrhosis: Identification with CT Portography

嚴重肝硬化離肝性門靜脈側枝通路：以CT門靜脈圖確認

姜仁惠(Jen-Huey Chiang) ； 李潤川(Rheun-Chuan Lee) ； 黃姍姒(Shan-Su Huang) ； 曾修山(Tsiu-Shan Tseng) ； 邱怡友(Yi-You Chiou) ； 王家槐(Jia-Hwia Wang) ； 刁翠美(Chui-Mei Tiu) ； 周宜宏(Yi-Hong Chou) ； 張政彥(Cheng-Yen Chang) ； 鄧木火(Mu-Huo Teng)

《中華放射線醫學雜誌》 31卷1期 (2006/02) Pp. 1-13

摘要

重度肝硬化病人病程緩慢卻多合併發生門靜脈高血壓症。病人門靜脈血壓增高，向肝性血行漸減，久之，曲張之側枝循環靜脈於是形成。在臨床上，醫師事先能確認病人之門靜脈血行狀況及側枝靜脈圖譜，對於治療計畫之擬定有極大的幫助。近年來，多切面電腦斷層攝影配合靜脈注射對比劑技術，對重度肝硬化病人提供品質極為優異的門靜脈及其側枝靜脈圖譜。自2004年元月至同年12月，本院148位肝硬化病人，利用16切面電腦斷層攝影機施行CT門靜脈攝影檢查，其中112人顯示為重度肝硬化合併門靜脈高血壓症性離肝性靜脈側枝循環。研究顯示它確實提供全方位高品質之側枝循環靜脈圖譜。對於側枝靜脈之確認以及治療方向之選擇，提供極為珍貴和正確的資料。

關鍵字

電腦斷層 ； 門靜脈攝影 ； 門靜脈側枝通路 ； 門靜脈高血壓症 ； 肝硬化症

並列摘要

Portal hypertension is a common syndrome that is characterized by pathologic increase in portal venous pressure and by the formation of portal systemic collaterals that shunt part of portal venous blood to the systemic circulation. Knowledge of hemodynamic circulation and portal venous collateral pathways is important for clinical physicians. Multi-detector row computed tomography (CT) offers important advantages over conventional imaging methods in the evaluation of the portal venous vasculature because of faster scanning and thinner collimation. These advances allow excellent visualization of the portal veins and hepatofugal collateral channels. Three-dimensional CT portography may also have technical potential to generate excellent image for volumetric reconstructions and hemodynamic evaluation of the portal vein and its collaterals. From January to December 2004, 148 patients with liver cirrhosis were enrolled for this study and hepatofugal collaterals were identified in 112 patients. Three-dimensional CT portography provided comprehensive mapping of vascular compromise and collateral formation and therefore, improved medical treatment quality.

並列關鍵字

Computed tomography CT ； portography ； Hepatofugal collaterals ； Liver cirrhosis ； Portal hypertension