遺傳性出血性毛細(xì)血管擴(kuò)張癥多排螺旋CT影像特征分析
發(fā)布時(shí)間：2018-11-14 08:38
【摘要】：目的總結(jié)遺傳性出血性毛細(xì)血管擴(kuò)張癥(hereditary hemorrhagic telangieetasia,HHT)患者多排螺旋CT(multi-detector helical computed tomography,MDCT)的影像學(xué)特征。方法回顧性分析14例HHT患者的MDCT影像特征,所有病例均行容積再現(xiàn)(VR)、最大密度投影(MIP)及多平面重建(MPR)。結(jié)果 14例患者中,肺部受累5例,CT軸位顯示結(jié)節(jié)狀或團(tuán)塊狀強(qiáng)化灶,VR及MIP顯示瘤體及供血?jiǎng)用}和引流靜脈。肝臟受累12例,包括肝動(dòng)脈-肝靜脈分流6例,肝動(dòng)脈-門(mén)靜脈分流2例,門(mén)靜脈-肝靜脈分流4例。肝動(dòng)脈-肝靜脈分流:軸位動(dòng)脈期可見(jiàn)肝門(mén)增粗、迂曲的血管影,肝靜脈提前顯影,MIP及VR顯示肝動(dòng)脈及其分支迂曲擴(kuò)張;肝動(dòng)脈-門(mén)靜脈分流:MIP及MPR肝動(dòng)脈和門(mén)靜脈同時(shí)顯影,MPR同時(shí)顯示肝內(nèi)多發(fā)斑片狀異常強(qiáng)化區(qū);門(mén)靜脈-肝靜脈分流:門(mén)靜脈期MPR及MIP可見(jiàn)門(mén)靜脈與肝靜脈分支間迂曲擴(kuò)張的交通血管及斑片狀強(qiáng)化區(qū)。胰腺受累5例,動(dòng)脈期MPR及MIP顯示胰頭周圍擴(kuò)張的血管團(tuán)2例及瘤樣擴(kuò)張1例,胰頭或胰尾部結(jié)節(jié)狀異常強(qiáng)化灶2例。脾臟受累1例,動(dòng)脈期MPR表現(xiàn)為脾臟內(nèi)多發(fā)斑片狀異常強(qiáng)化灶及脾動(dòng)脈瘤形成。小腸受累1例,VR及MIP顯示為腸系膜上靜脈分支遠(yuǎn)端迂曲的血管團(tuán)。結(jié)論 HHT累及多臟器的影像表現(xiàn)具有特異性,CT血管重建能夠清晰顯示HHT的血管變異,MDCT有助于臨床診斷。
[Abstract]:Objective to summarize the imaging features of multiple helix CT (multi-detector helical computed tomography,MDCT) in patients with hereditary hemorrhagic telangiectasia (hereditary hemorrhagic telangieetasia,HHT). Methods the MDCT imaging features of 14 patients with HHT were retrospectively analyzed. All patients underwent volume reconstruction (VR), maximum density projection (MIP) and multiplanar reconstruction (MPR). Results in 14 cases, pulmonary involvement was found in 5 cases. CT showed nodular or mass enhancement on axis, and VR and MIP showed tumor and supplying artery and drainage vein. There were 12 cases of hepatic involvement, including 6 cases of hepatic arterial-hepatic shunt, 2 cases of hepatic arterial-portal shunt and 4 cases of portal-hepatic vein shunt. Hepatic arterial-hepatic vein shunt: hepatic porta was thickened and tortuous vessels were seen in axial phase, hepatic vein was developed ahead of time, MIP and VR showed hepatic artery and its branches tortuous dilatation. Hepatic arterial-portal shunt: MIP and MPR showed hepatic artery and portal vein at the same time, and MPR showed multiple patchy enhancement areas in liver simultaneously. Portal-hepatic shunt: MPR and MIP in portal vein phase showed tortuous dilated communicating vessels and patchy enhancement area between portal vein and hepatic vein branches. There were 5 cases of pancreatic involvement, 2 cases of vasodilation around the head of pancreas, 1 case of tumor-like dilatation, 2 cases of nodular enhancement of pancreatic head or tail, and 2 cases of abnormal enhancement of pancreatic head or tail on MPR and MIP. Splenic involvement occurred in 1 case, and MPR showed multiple plaque enhancement and splenic aneurysm formation. The small intestine was involved in one case. VR and MIP showed that the superior mesenteric vein branch was a convoluted vessel mass at the distal end. Conclusion the imaging features of HHT involving multiple organs are specific. The vascular remodeling of CT can clearly show the vascular variation of HHT. MDCT is helpful for clinical diagnosis.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京佑安醫(yī)院放射科;鄭州市第六人民醫(yī)院放射科;
【分類號(hào)】：R543;R816.2
，
本文編號(hào)：2330677
[Abstract]:Objective to summarize the imaging features of multiple helix CT (multi-detector helical computed tomography,MDCT) in patients with hereditary hemorrhagic telangiectasia (hereditary hemorrhagic telangieetasia,HHT). Methods the MDCT imaging features of 14 patients with HHT were retrospectively analyzed. All patients underwent volume reconstruction (VR), maximum density projection (MIP) and multiplanar reconstruction (MPR). Results in 14 cases, pulmonary involvement was found in 5 cases. CT showed nodular or mass enhancement on axis, and VR and MIP showed tumor and supplying artery and drainage vein. There were 12 cases of hepatic involvement, including 6 cases of hepatic arterial-hepatic shunt, 2 cases of hepatic arterial-portal shunt and 4 cases of portal-hepatic vein shunt. Hepatic arterial-hepatic vein shunt: hepatic porta was thickened and tortuous vessels were seen in axial phase, hepatic vein was developed ahead of time, MIP and VR showed hepatic artery and its branches tortuous dilatation. Hepatic arterial-portal shunt: MIP and MPR showed hepatic artery and portal vein at the same time, and MPR showed multiple patchy enhancement areas in liver simultaneously. Portal-hepatic shunt: MPR and MIP in portal vein phase showed tortuous dilated communicating vessels and patchy enhancement area between portal vein and hepatic vein branches. There were 5 cases of pancreatic involvement, 2 cases of vasodilation around the head of pancreas, 1 case of tumor-like dilatation, 2 cases of nodular enhancement of pancreatic head or tail, and 2 cases of abnormal enhancement of pancreatic head or tail on MPR and MIP. Splenic involvement occurred in 1 case, and MPR showed multiple plaque enhancement and splenic aneurysm formation. The small intestine was involved in one case. VR and MIP showed that the superior mesenteric vein branch was a convoluted vessel mass at the distal end. Conclusion the imaging features of HHT involving multiple organs are specific. The vascular remodeling of CT can clearly show the vascular variation of HHT. MDCT is helpful for clinical diagnosis.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京佑安醫(yī)院放射科;鄭州市第六人民醫(yī)院放射科;
【分類號(hào)】：R543;R816.2
，
本文編號(hào)：2330677
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