Diagnostic Value Of Multi-slice CT In Pancreatogenic Regional Portal Hypertension

Objective-To investigate the value of multi-slice CT(MSCT) and post-processing techniques in clinical settings and imaging diagnosis of pancreatogenic regional portal hypertension and have a correlation research between pancreatogenic regional portal hypertension and post-hepatitis portal hypertension.Methods-A 16-detector row spiral CT scanner(GE Lightspeed 16CT 99OCO machine-type)was used to perform plain scanning and contrast enhanced abdominal scanning in 214 patients with pancreatogenic regional portal hypertension and post-hepatitis portal hypertension.Scanning parameters:tube tension 120kV,tube current 250mA; pitch 1.375:1,matrix 512×512,slice thickness 10mm. Scanning range:from the diaphragmatic dome to the level of the crest of ilium. All of the patients were injected non-ion contrast material 80ml mer-ulnar vein with high pressure syringe,rate of flow : 3ml/s, 71 of the patients were used three stage scanning(arterial phase,portal vein phase and lag period),183 of the patients were used two stage scanning(arterial phase and portal vein phase). The images of the arterial phase,portal vein phase and lag period were gained respectively 30s,55s and 5min after injecting the contrast material. Source images were reconstructed into images with slice-thickness of 0.625mm and were transported into a workstation(GE AW4.2)with which post-processing was conducted. Various image post-processing techniques such as MPR,MIP,VRT,etc. were applied . 27 of the patients displayed that the tension of the veins in the area of the spleen and stomach was high and the main portal vein was normal.There was a contrasting research about primitive image of perigastric varicose vein between pancreatogenic regional portal hypertension and post-hepatitis portal hypertension.Results -Tortuous and dilated varicose veins were displayed at various locations.In the thick slice presentation with the primitive axial surface of the 27 patients with pancreatogenic regional portal hypertension, the coronary gastric vein(CGV) was displayed in 12 patients,the display rate was 44%; the short gastric vein(SGV) was displayed in 22 patients,the display rate was 80%; the gastroepiploic vein (GEV) was displayed in 23 patients,the display rate was 85%; the gastric basement vein(GBV) was displayed in 20 patients,the display rate was 74%;the esophageal vein (EV) was displayed in 4 patients,the display rate was 15%;the splenic renal vein(SKV) was displayed in 25 patients,the display rate was 93%. The display rate of the aforesaid vessels in the lamellar scan and reconstruction image was respectively 52%,89%,89%,78%,19%,96%.Otherwise, the gastrocolic trunk(GCT) was displayed in 9 patients,the display rate was 30% and the display rate of the vessel in the lamellar scan and reconstruction image was 52%. Two of all the patients had superior mesenteric vein obstruction except splenic vein obstruction,the indirect signs was the variciform of some of the main group,including the gastrocolic trunk(GCT),right gastroepiploic vein(RGV),pancreaticodudenal anterosuperior vein,colonic right upper vein,intermediate vein,the primary image in MSCT was variciform vascular imaging in anterior aspect of the uncinate process of pancreas.The splenic artery and splenic vein were involved in one tail of pancreatic carcinoma,spleen metabolic effect was caused by the reduction of the blood supply of the splenic artery,in the end,it caused the spleen infarct.In the thick slice presentation with the primitive abscissa axial surface of the 40 patients with post-hepatitis portal hypertension, the display rate of the aforesaid vessels in the primary image was respectively 100%,25%,17%,100%,100%,93%. Between the two units,the variciform rate of EV,GBV,GCV of PSPH unit was lower conspicuously than PS unit (P< 0.005,< 0.05,< 0.025), the variciform rate of SGV and GEV of PSPH unit was higher conspicuously than PS unit (P < 0.005,meanly).There was no significant deviation about SKV between the two units.Conclusions-The sensibility and accuration was higher to diagnose PSPH using MSCT and image postprocessing techniques,it could display the collateral circulation of portal hypertension from various location,it had significant clinical guidance value for modus operandi of PSPH.There was significant deviation between pancreatogenic regional portal hypertension and post-hepatitis portal hypertension,and it could identify with post-hepatitis portal hypertension.