【摘要】：目的總結遺傳性出血性毛細血管擴張癥(hereditary hemorrhagic telangieetasia,HHT)患者多排螺旋CT(multi-detector helical computed tomography,MDCT)的影像學特征。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)。結果 14例患者中,肺部受累5例,CT軸位顯示結節(jié)狀或團塊狀強化灶,VR及MIP顯示瘤體及供血動脈和引流靜脈。肝臟受累12例,包括肝動脈-肝靜脈分流6例,肝動脈-門靜脈分流2例,門靜脈-肝靜脈分流4例。肝動脈-肝靜脈分流:軸位動脈期可見肝門增粗、迂曲的血管影,肝靜脈提前顯影,MIP及VR顯示肝動脈及其分支迂曲擴張;肝動脈-門靜脈分流:MIP及MPR肝動脈和門靜脈同時顯影,MPR同時顯示肝內多發(fā)斑片狀異常強化區(qū);門靜脈-肝靜脈分流:門靜脈期MPR及MIP可見門靜脈與肝靜脈分支間迂曲擴張的交通血管及斑片狀強化區(qū)。胰腺受累5例,動脈期MPR及MIP顯示胰頭周圍擴張的血管團2例及瘤樣擴張1例,胰頭或胰尾部結節(jié)狀異常強化灶2例。脾臟受累1例,動脈期MPR表現(xiàn)為脾臟內多發(fā)斑片狀異常強化灶及脾動脈瘤形成。小腸受累1例,VR及MIP顯示為腸系膜上靜脈分支遠端迂曲的血管團。結論 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】：R543;R816.2
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本文編號：2330677