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MRI Study of Cavernous Transformation of Portal Vein
ABSTRACT
Objective: To investigate the MR plain scan, dynamic enhancement and dynamic contrast-enhanced magnetic resonance angiography(DCE-MRA) features of cavernous transformation of portal vein(CTPV), and to evaluate the diagnostic value of MRI.
Materials and Methods: The MR plain scan, dynamic enhancement and DCE-MRA features of surgery and pathology or DSA proved CTPV in 28 patients were reviewed retrospectively.
Results: The features of CTPV: The obturation of portal vein was shown in plain scan, abnormal agglomerative and reticular soft tissue signals could be visualized in plain scan too. Abnormal perfusion of liver blood could be seen in arterial phase during MR dynamic enhancement, abnormal collateral branch veins were enhanced during the portal phase. The above-mentioned alterations were displayed more directly in DCE-MRA.
Conclusion: CTPV has characteristic MR plain scan, dynamic enhancement and DCE-MRA features, it is important in diagnose CTPV.
Key words: Portal vein Cavernous transformation Magnetic resonance imaging Magnetic resonance angiography
门静脉海绵样变性（cavernous transformation of portal vein，CTPV）是指在由不同病因所致门静脉主干和（或）分支完全或部分阻塞或闭塞后，在其周围形成大量的微小静脉，呈海绵状血管瘤样改变，故称门静脉海绵样变性。随着影像技术的发展，CT、DSA、MRI诊断CTPV 的报道越来越多，CT能了解CTPV的存在及肝脏的灌注情况[1]，但CTA直观显示CTPV的侧支循环及门脉高压效果欠佳；DSA虽然认为是诊断CTPV的较好方法之一，但具有一定的创伤性。随着MRI技术的发展，在显示腹部血管病变方面，DCE-MRA与DSA具有良好的一致性[2]，而且MRI动态增强扫描能显示肝脏的灌注情况。本研究旨在初步探讨MRI尤其是DCE-MRA及动态增强扫描对CTPV的诊断价值。<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
材料与方法
一、一般资料
对28例不同病因所致的CTPV患者行MRI平扫及动态增强扫描或门静脉DCE-MRA检查，其中男16例，女12例，年龄1岁~76岁（平均50.5岁）,所有病例均经手术病理或DSA证实。
二、检查方法
MRI使用GE 1.5T Signa CV/i MR机，行常规横轴面SS-FSE序列上腹部定位；横轴面SE序列T1WI饱和抑脂; 横轴面快速自旋回波序列（FSE）T2WI加饱和抑脂,层厚3~5mm, 层间距1mm,矩阵256×256或256×192，激励次数1次，视野320mm×320mm。
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