本文選題：先天性門體分流　切入點：Abernethy畸形　出處：《中國循證兒科雜志》2017年05期

【摘要】：目的探討合并消化道出血的先天性門體分流畸形的影像學特征,以提高對該畸形的認識。方法納入復(fù)旦大學附屬兒科醫(yī)院病歷系統(tǒng)中先天性門體分流且病史中有消化道出血癥狀的病例,采集性別、年齡、臨床表現(xiàn)、CTA和MRA影像學資料、外科手術(shù)結(jié)局。CTA為GE Light speed 64排螺旋CT掃描儀,MRA為Siemens Avanto 1.5 T掃描儀,提取納入病例的CTA原始圖像,以1.25 mm層厚/0.625 mm層間隔重建,傳入后處理工作站進行多平面重建;提取納入病例的MRA原始圖像,傳入MR工作站進行后期多平面重建;由2名從事兒科影像診斷10年以上醫(yī)生獨立讀片,觀察門靜脈及其屬支的形態(tài)及走行,異常門體分流位置、途徑,髂靜脈、下腔靜脈及腸管、腸壁血管分布。結(jié)果 2008年3月至2017年1月符合本文病例納入標準的連續(xù)病例8例,男6例,年齡3月至10歲,7例貧血,7例便血,1例嘔血。8例均行CTA檢查,其中2例同時行MRA檢查。截止出院時,6例行手術(shù)治療,2例隨訪觀察。8例先天性門體分流畸形患兒均為肝外型門體分流,2例肝外型Ⅰ型,6例為Ⅱ型。以便血為表現(xiàn)的7例中,髂內(nèi)靜脈、直腸上靜脈及結(jié)腸靜脈擴張扭曲;以嘔血為表現(xiàn)的1例,脾靜脈和腸系膜上靜脈匯合后通過胃冠狀靜脈匯入左腎靜脈,胃冠狀靜脈顯著擴張、扭曲。結(jié)論合并便血的先天性門體分流大部分通過腸系膜下靜脈與髂靜脈異常溝通,發(fā)生便血的比例高。
[Abstract]:Objective to investigate the congenital portosystemic shunt combined with hemorrhage of digestive tract malformation imaging features, in order to improve the understanding of this deformity. Methods included symptomatic gastrointestinal bleeding cases, congenital portal Paediatrics Hospital Affiliated to Fudan University medical record system in history and distributary acquisition of gender, age, clinical manifestations, imaging data of CTA and MRA, surgery.CTA GE Light speed for the surgical outcome of 64 slice spiral CT scanner, MRA Siemens Avanto 1.5 T scanner, CTA extraction into the original image case, with a thickness of 1.25 mm /0.625 mm reconstruction interval, the incoming postprocessing workstation for multi planar reconstruction; extracting the original image into the MRA case, the incoming MR workstation for multi planar later reconstruction; by 2 more than 10 years engaged in pediatric imaging diagnosis of doctor independent reading, observation of portal vein and its tributaries form and running, the abnormal position of portosystemic shunt, iliac vein approach, The inferior vena cava and intestine, bowel wall vascularity. 8 consecutive cases from March 2008 to January 2017 results in line with the inclusion criteria, 6 cases were male, age from March to 10, 7 cases of anemia, 7 cases of blood in the stool, 1 cases of hematemesis.8 cases were examined by CTA, 2 cases underwent MRA examination. The hospital stop, 6 cases of surgical treatment, follow-up observation of 2 cases of.8 patients with congenital portosystemic shunt deformity patients had extrahepatic portosystemic shunt, 2 cases of extrahepatic type, 6 cases of type II. In 7 cases with hematochezia, iliac vein, superior rectal vein and vein dilatation in colonic distortion; 1 cases of haematemesis, splenic vein and superior mesenteric vein after confluence through gastric coronary vein enters the left renal vein, gastric coronary vein dilation, with distortion. Conclusion hematochezia congenital portosystemic shunt mostly through vein and iliac vein inferior mesenteric abnormal communication, bloody stool is high.

【作者單位】： 復(fù)旦大學附屬兒科醫(yī)院放射科;廈門市兒科醫(yī)院放射科;
【分類號】：R445.2;R725.7

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本文編號：1663308