Clinical Application of Multi-Slice Spiral CT in Portal Vein Imaging_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Peng ¹ , HE Yongbin ² , LI Jiarui ³ , WANG Xinmiao ² , ZHANG Baiqiu ¹ ,  WANG Dawei ³

1.Department of Interventional Radiology, Changchun City Central Hospital, Changchun 130051, China;;
2.Department of Radiology, Changchun City Central Hospital, Changchun 130051, China;;
3.Department of Interventional Radiology, The First Hospital of Jilin University, Changchun 130021, China;

Corresponding author：

WANG Dawei, Email: JLwdw@sina.com

Keywords：

Multi-slice spiral CT; Portal vein; Three-dimensional reconstruction; CT angiography

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Objective To study the clinical significance of multi-slice spiral CT in portal vein imaging. Methods One hundred and thirty seven cases underwent enhanced scan with GE Light SpeedQX/i4 CT scanner were collected, including 41 cases of liver cancer, 20 cases of hepatic cirrhosis, 21 cases of cavernous hemangioma of liver, 9 cases of hepatic abscess, 6 cases of carcinoma of gallbladder, 14 cases of cholangiocarcinoma, 16 cases of pancreatic carcinoma, and 5 cases in normal. The results of portal vein images were reconstructed with three-dimensional software and analyzed. Results In 109 cases, portal vein, cranial mesenteric vein, and splenic vein were demonstrated successfully in the stage of portal vein: volume rendering images were clear in 84 cases, and maximum intensity projection images and multiplanar reconstruction images were clear in 109 cases. Forty-five cases of portal hypertension, 18 cases of opened collateral circulation, 15 cases of portal vein tumor thrombus, 1 case of splenic vein tumor thrombus, and 6 cases of large cavernous hemangioma were demonstrated successfully. Conclusion The portal vein imaging with multi-slice spiral CT can show the dissection and lesions of portal vein and its branches clearly, and can provide the clinical evidence for clinicians to formulate a treatment plan correctly.

Citation： SUN Peng ,HE Yongbin,LI Jiarui,WANG Xinmiao,ZHANG Baiqiu,WANG Dawei. Clinical Application of Multi-Slice Spiral CT in Portal Vein Imaging. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1318-1321. doi: Copy

1.	郭成伟, 梁文, 全显跃, 等. 64层螺旋CT门静脉三维成像变异分析及其在临床中的应用 [J]. 中国实用外科杂志, 2008; 28(8): 641-643.
2.	Fischer L, Cardenas C, Thorn M, et al. Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis [J]. J Comput Assist Tomogr, 2002; 26(6): 962-967.
3.	薛彩霞. MSCT门静脉重建技术的临床应用 [J]. 实用医学影像杂志, 2006; 7(3): 189-191.
4.	朱康顺, 李征然, 孟晓春, 等. 门静脉高压症胃静脉曲张的血流动力学研究: 附22例直接门静脉造影结果 [J]. 中国医学影像技术, 2006; 22(11): 1700-1703.
5.	Kim HC, Kim TK, Sung KB, et al. CT during hepatic arteriography and portography: an illustrative review [J]. Radiographics, 2002; 22(5): 1041-1051.
6.	Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications [J]. Radiographics, 2000; 20(6): 1787-1806.
7.	Onodera Y, Omatsu T, Nakayama J, et al. Peripheral anatomic evaluation using 3D CT hepatic venography in donors: significance of peripheral venous visualization in living-donor liver transplantation [J]. AJR Am J Roentgenol, 2004; 183(4): 1065-1070.
8.	Ichikawa T, Erturk SM, Araki T. Multiphasic contrast-enhanced multidetector-row CT of liver: contrast-enhancement theory and practical scan protocol with a combination of fixed injection duration and patients’ body-weight-tailored dose of contrast material [J]. Eur J Radiol, 2006; 58(2): 165-176.
9.	Fishman EK. From the RSNA refresher courses: CT angiography: clinical applications in the abdomen [J]. Radiographics, 2001; 21: S3-S16.
10.	张志伟, 陈孝平, 胡道予, 等. 多排螺旋CT三维重建在肝脏外科中的应用 [J]. 中国实用外科杂志, 2004; 24(11): 666-668.
11.	Calhoun PS, Kuszyk BS, Heath DG, et al. Three-dimensional volume rendering of spiral CT data: theory and method [J]. Radiographics, 1999; 19(3): 745-764.
12.	路涛, 周翔平. 多层螺旋CT肝血管三维重建及临床应用 [J]. 中国普外基础与临床杂志, 2006; 13(2): 233-236.
13.	董丽卿, 郑祥武, 杨运俊, 等. MSCT选择性VR及其肝脏门脉系统成像 [J]. 中国医学影像学杂志, 2007; 15(4): 266-269.
14.	李大庆, 舒圣捷, 高丽, 等. 64层螺旋CT门静脉重建技术在肝癌合并癌栓的诊断价值 [J]. 哈尔滨医科大学学报, 2008; 42(4): 409-411.
15.	陈青华, 王洪波, 柳澄. 螺旋CT血管成像在腹部的应用进展 [J]. 国外医学临床放射学分册, 2005; 28(2): 78-82.
16.	史琲, 朱晖, 吴云林, 等. 门脉CTA及内镜对胃静脉曲张诊断及疗效评估的比较研究 [J]. 胃肠病学和肝病学杂志, 2007; 16(6): 507-511.
17.	Soyer P, Heath D, Bluemke DA, et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques [J]. J Comput Assist Tomogr, 1996; 20(1): 122-127.
18.	陈丽娜, 吴云林. 门静脉CT血管造影在门静脉高压检查中的临床应用 [J]. 诊断学理论与实践, 2006; 5(3): 269-272.
19.	印隆林, 宋彬, 陈卫霞, 等. 多排螺旋CT血管成像技术对门静脉海绵样变性侧支血管的显示 [J]. 中国普外基础与临床杂志, 2004; 11(6): 547-550.
20.	Hopper KD, Iyriboz AT, Wise SW, et al. Mucosal detail at CT virtual reality: surface versus volume rendering [J]. Radiology, 2000; 214(2): 517-522.
21.	Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices [J]. AJR Am J Roentgenol, 2001; 176(4): 899-905.
22.	Chopra S, Dodd GD 3rd, Chintapalli KN, et al. Transjugular intrahepatic portosystemic shunt: accuracy of helical CT angiography in the detection of shunt abnormalities [J]. Radiology, 2000; 215(1): 115-122.
23.	李康, 吕富荣, 马千红, 等. 食管胃静脉曲张供血与分流血管CT三维成像研究 [J]. 中国临床解剖学杂志, 2009; 27(2): 184-186.
24.	靳勇, 林晓珠, 瞿晴, 等. 门静脉CTA在门静脉高压门体分流侧支血管显示中的应用 [J]. 临床放射学杂志, 2008; 27(12): 1675-1679.
25.	De Gaetano AM, Lafortune M, Patriquin H, et al. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography [J]. AJR Am J Roentgenol, 1995; 165(5): 1151-1155.
26.	Song B, Min P, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels [J]. Abdom Imaging, 2000; 25(4): 385-393.

1. 郭成伟, 梁文, 全显跃, 等. 64层螺旋CT门静脉三维成像变异分析及其在临床中的应用 [J]. 中国实用外科杂志, 2008; 28(8): 641-643.
2. Fischer L, Cardenas C, Thorn M, et al. Limits of Couinaud’s liver segment classification: a quantitative computer-based three-dimensional analysis [J]. J Comput Assist Tomogr, 2002; 26(6): 962-967.
3. 薛彩霞. MSCT门静脉重建技术的临床应用 [J]. 实用医学影像杂志, 2006; 7(3): 189-191.
4. 朱康顺, 李征然, 孟晓春, 等. 门静脉高压症胃静脉曲张的血流动力学研究: 附22例直接门静脉造影结果 [J]. 中国医学影像技术, 2006; 22(11): 1700-1703.
5. Kim HC, Kim TK, Sung KB, et al. CT during hepatic arteriography and portography: an illustrative review [J]. Radiographics, 2002; 22(5): 1041-1051.
6. Rydberg J, Buckwalter KA, Caldemeyer KS, et al. Multisection CT: scanning techniques and clinical applications [J]. Radiographics, 2000; 20(6): 1787-1806.
7. Onodera Y, Omatsu T, Nakayama J, et al. Peripheral anatomic evaluation using 3D CT hepatic venography in donors: significance of peripheral venous visualization in living-donor liver transplantation [J]. AJR Am J Roentgenol, 2004; 183(4): 1065-1070.
8. Ichikawa T, Erturk SM, Araki T. Multiphasic contrast-enhanced multidetector-row CT of liver: contrast-enhancement theory and practical scan protocol with a combination of fixed injection duration and patients’ body-weight-tailored dose of contrast material [J]. Eur J Radiol, 2006; 58(2): 165-176.
9. Fishman EK. From the RSNA refresher courses: CT angiography: clinical applications in the abdomen [J]. Radiographics, 2001; 21: S3-S16.
10. 张志伟, 陈孝平, 胡道予, 等. 多排螺旋CT三维重建在肝脏外科中的应用 [J]. 中国实用外科杂志, 2004; 24(11): 666-668.
11. Calhoun PS, Kuszyk BS, Heath DG, et al. Three-dimensional volume rendering of spiral CT data: theory and method [J]. Radiographics, 1999; 19(3): 745-764.
12. 路涛, 周翔平. 多层螺旋CT肝血管三维重建及临床应用 [J]. 中国普外基础与临床杂志, 2006; 13(2): 233-236.
13. 董丽卿, 郑祥武, 杨运俊, 等. MSCT选择性VR及其肝脏门脉系统成像 [J]. 中国医学影像学杂志, 2007; 15(4): 266-269.
14. 李大庆, 舒圣捷, 高丽, 等. 64层螺旋CT门静脉重建技术在肝癌合并癌栓的诊断价值 [J]. 哈尔滨医科大学学报, 2008; 42(4): 409-411.
15. 陈青华, 王洪波, 柳澄. 螺旋CT血管成像在腹部的应用进展 [J]. 国外医学临床放射学分册, 2005; 28(2): 78-82.
16. 史琲, 朱晖, 吴云林, 等. 门脉CTA及内镜对胃静脉曲张诊断及疗效评估的比较研究 [J]. 胃肠病学和肝病学杂志, 2007; 16(6): 507-511.
17. Soyer P, Heath D, Bluemke DA, et al. Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques [J]. J Comput Assist Tomogr, 1996; 20(1): 122-127.
18. 陈丽娜, 吴云林. 门静脉CT血管造影在门静脉高压检查中的临床应用 [J]. 诊断学理论与实践, 2006; 5(3): 269-272.
19. 印隆林, 宋彬, 陈卫霞, 等. 多排螺旋CT血管成像技术对门静脉海绵样变性侧支血管的显示 [J]. 中国普外基础与临床杂志, 2004; 11(6): 547-550.
20. Hopper KD, Iyriboz AT, Wise SW, et al. Mucosal detail at CT virtual reality: surface versus volume rendering [J]. Radiology, 2000; 214(2): 517-522.
21. Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices [J]. AJR Am J Roentgenol, 2001; 176(4): 899-905.
22. Chopra S, Dodd GD 3rd, Chintapalli KN, et al. Transjugular intrahepatic portosystemic shunt: accuracy of helical CT angiography in the detection of shunt abnormalities [J]. Radiology, 2000; 215(1): 115-122.
23. 李康, 吕富荣, 马千红, 等. 食管胃静脉曲张供血与分流血管CT三维成像研究 [J]. 中国临床解剖学杂志, 2009; 27(2): 184-186.
24. 靳勇, 林晓珠, 瞿晴, 等. 门静脉CTA在门静脉高压门体分流侧支血管显示中的应用 [J]. 临床放射学杂志, 2008; 27(12): 1675-1679.
25. De Gaetano AM, Lafortune M, Patriquin H, et al. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography [J]. AJR Am J Roentgenol, 1995; 165(5): 1151-1155.
26. Song B, Min P, Oudkerk M, et al. Cavernous transformation of the portal vein secondary to tumor thrombosis of hepatocellular carcinoma: spiral CT visualization of the collateral vessels [J]. Abdom Imaging, 2000; 25(4): 385-393.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Application of Multi-Slice Spiral CT in Portal Vein Imaging

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