The Preoperative Values Of Multi-slice CT Portography (MSCTP) In Embolization Of Gastroesophageal Varices

ObjectiveTo demonstrate the collateral vessels better in the patients with portal hypertension and to investigate the preoperative values of Multi-slice CT portography in embolization of gastroesophageal varices through the study of MSCTP technology.Materials and methods78 patients with portal hypertension accompanying gastroesophageal varices verified by the endoscopy were given a conrtrast scanning of 64-slice CT in this study. Inclued male 43,female 35;age ranged 17-19 years old,average 53.2.In this study, 42 patients accompanying gastroesophageal bleeding and demonstrated their gastroesophageal varices and its related collateral vessels by 64-slice CT portography were performed embolization of gastroesophageal varices,x~2 test was used to detect the differences of 64-SCTP and digital subtraction angiography(DSA)in demonstrating varices and its related collateral vessels.Images were required on 64-slice CT.Take orally 600-800 ml water before examination.The contrast dose was 1.5-2.0 ml/kg and injection rates of contrast material was 3.5 ml/s.The scan delay time was 60-70s.We used a 2.0-mm section thickness with image data reconstructed at 1.0-mm interwals during the portal venous phase.Image post-processing techniques such as MIP,MPR and VR were applied to display the portosystemic collaterals of portal venous system on Somatom Senstation Wizard Workstation.Angiographic images involve the portal vein,the superior mesenteric vein,the splenic vein,the inferior mesenteric vein,the gastroesophageal varices and its related collateral vessels et al.The gastroesophageal varices were devided in three types which have gastroesophageal varicesⅠ(GEV1),gastroesophageal varicesⅡ(GEV2),isoalated gastric varices(IGV).The related collateral vessels include left gastric vein(LGV), posterior gastric vein(PGV),short gastric vein(SGV).To contrast detect the differences of 64-SCTP and direct angiographic portography in demonstrating varices and its related collateral vessels with SPSS 12.0.It has no significant differences when p＞0.05.ResultsGastroesophageal varices:Of 78 patients with gastroesophageal varices on 64-SCTP(100%):GEV1 46(59%),GEV2 23(29%),IGV 9(12%),gastroesophageal varices with_paraesophageal veins 23.Related collateral vessels:Of 78 patients with gastroesophageal varices on 64-SCTP,56 were found in left gastric veins(86%),18 in posterior/short gastric veins(32%),7 in gastrorenal or spenorenal shunts(11%),and 9 were found with cavernous transformation(12%).According to x~2 test,64-SCTP and DAP has no significant differences in demonstrating varices and its related collateral vessels(x~2=2.00 P＞0.05).Other collateral vessels:Paraumbilical vein were found in 8 patients, abdominal wall veins in 5,azygos vein and hemiazygos vein in 31,lumbar veins in 5.Thrombus:Of 78 patients with gastroesophageal varices on 64-SCTP,9 were found with thrombus in portal vein,2 with partial thrombus in portal vein and 1 with partial thrombus in splenic vein.ConclusionsMSCTP can confirm gastroesophageal varices and its related collateral vessels, detect whether there is thrombus and its extent,which makes it easier to select therapeutic regimen and shorten therapeutic time and evaluate the effectiveness of therapy.