| PART ONE: INVESTIGATE THE VENOUS DRAINAGEOF THE SPLENIC VEIN AND THE SUPERIORMESENTERIC VEINObjective:To investigate the sequence of venous drainage between the splenicvein (SpV) and the superior mesenteric vein (SMV) with multislice spiralCT.Methods:Retrospectively analyzed60patients who had undergoing contrastenhancement abdominal CT scan. Its dosage and velocity of contrastagent injection and scanning parameters had fixed. After30s and65s ofinjection the contrast agent, we measured the CT number of SpV andSMV respectively. At arterial phase divided the one who had enhancedSpV and non-enhanced SMV into A group, others into B group. Toanalyze the contrast enhancement difference between the blood of SpVand SMV in all the60cases as well as in A and B group. Results:①In arterial phase, the mean CT number in SpV was176.53HU±46.84HU, while that in SMV was119.53HU±48.99HU. The mean CTnumber of SpV was higher than SMV (t=-8.58, P<0.0001); In venousphase, the mean CT number in SpV was174.58HU±28.27HU, whilethat in SMV was179.35HU±27.26HU. There was no significantdifference between SpV and SMV (t=-0.94, P=0.35).②The ratio in Agroup was16.67%(10/60) and that in B group was83.33%(50/60). In Agroup, the mean CT number of arterial and venous phase were65.83±9.40HU and181.70±23.14HU respectively in SMV, while thatin SpV were155.53±30.93HU and175.83±29.45HU. In B group, themean CT number of arterial and venous phase were130.27±46.56HUand178.8±28.19HU respectively in SMV, while that in SpV180.73±48.56HU and174.33±28.33HU。The CT number of SMVdiffered significantly between A and B group (P＜0.05) in arterial phase,while in venous phase there was no significant difference (P＞0.05).There did not have significant difference in SpV between A and B groupin both arterial phase and venous phase (P＞0.05). In A group, the CTnumber of SMV in arterial phase was115.87±24.03HU higher than thatin venous phase (P＜0.05), while the CT number of SpV between arterialand venous phase did not have significant difference (P＞0.05). In Bgroup, the CT number of SMV in arterial phase were significant higher than that in venous phase (P＜0.05), while the CT number of SpVbetween arterial and venous phase did not have significant difference (P＞0.05).Conclusion:Multislice spiral CT can clearly display the SpV and SMV return.The drainage time of SpV is earlier than SMV.16.67%of60cases haveenhanced SpV and non-enhanced SMV in arterial phase. PART TWO: INVESTIGATE OF INTRAPORTALVENOUS FLOW DISTRIBUTION BY MULTISLICESPIRAL CTObjective:To investigate intraportal and intrahepatic venous flow distributionrules between SpV and SMV with multislice spiral CT. In order toprovide image data for clinical research.Methods:Retrospectively analyzed165patients that had undergoing contrastenhancement abdominal CT scan which can distinguish the enhancedSpV and the non-enhanced SMV in arterial phase. To observe the venousflow distribution in the main portal vein from the SpV and the SMV. To measure the CT number of the plain scan and contrast enhancementarterial phase in the left portal vein (LPV)、the right portal vein (RPV)、the left lobe of liver and the right lobe of liver. To analysis the blooddistribution rules of the portal vein. To measure the caliber of the MPV,SpV, SMV, RPV and LPV as well as the angle between SpV and SMVSpV and MPV, SMV and MPV, LPV and RPV, LPV and MPV, RPVand MPV. In order to analyze if there were some correlation in angle orvenous caliber with the rules of intraportal and intrahepatic blooddistribution.Results:①We divided all the165cases into three groups A, B and Caccording to the different pattern of SpV and SMV blood distribution inMPV. They were streamline distribution (A group) who’s ratio was61.81%(102/165), spiral distribution (B group) who’s ratio was24.84%(41/165), turbulence distribution (C group) who’s ratio was13.33%(22/165).②The mean CT number of plain scan in LPV was39.33HU±5.85HU, while that in RPV was38.76HU±5.54HU. The meanCT number of arterial phase in LPV was105.20HU±31.87HU, whilethat in RPV was93.23HU±27.94HU. The mean CT number of plainscan in the left lobe of liver was54.96HU±12.49HU, while that in theright lobe of liver was53.29HU±14.45HU. The mean CT number ofarterial phase in the left lobe of liver was72.48HU±17.91HU, while that in the right lobe of liver was65.75HU±15.91HU. In arterial phase,contrasting the ratio of the CT number in the LPV and the RPV, therewere84.24%(139/165) higher (a group) and15.76%(26/165) lower (bgroup). Contrasting the ratio of the CT number in the left and right lobeof liver, there were85.45%(141/165) higher (c group) and15.55%(24/165) lower (d group). Of all the165cases including A, Band C group, the CT number had significant difference between theLPV and RPV and between the left and right lobe of liver (P＜0.01) inarterial phase. However there was on significant difference betweenthem in plain scan(P＞0.05).③There had significant differencebetween a and b group in the angle between RPV and LPV, MPV andLPV (P＜0.05). There was no significant difference between them inthe angle between MPV and RPV (P＞0.05). There was no significantdifference in caliber in MPV,RPV and LPV (P＞0.05). Between c and dgroup all of the angel and caliber did not have significant difference (P＞0.05).④There had significant difference between A, B and C groupin the angle between SpV and SMV (P＜0.05), the angle between SpV andSMV increased progressively in A, B and C group. But that betweenSpV and MPV, SMV and MPV did not have significant difference andthere were no significant difference in caliber in SpV, SMV and MPV(P＞0.05). Between A and B group, there were no significant differencein the angle between SpV and SMV, SpV and MPV, SMV and MPV (P ＞0.05) and as well as the caliber in SpV, SMV and MPV (P＞0.05).There had significant difference between A and C group in the anglebetween SpV and SMV, SpV and MPV (P＜0.05), but that betweenSMV and MPV did not have significant difference and there was nosignificant difference in caliber in SpV, SMV and MPV (P＞0.05).Between B and C group, there had significant difference in the anglebetween SpV and MPV (P＜0.05) but that between SpV and SMV,SMV and MPV did not have significant difference (P＞0.05). There hadsignificant difference in caliber in SMV (P＜0.05) between B and Cgroup, but that in SpV and MPV did not have significant difference (P＞0.05).Conclusion:Our results suggest that the distribution patterns of intraportalvenous flow are streamline, spiral, and turbulence. The angle betweenSpV and SMV, SpV and MPV, and the caliber in MPV have somethingto do with the blood distribution of introportal venous flow. The anglesbetween LPV and RPV, MPV and LPV have something to do with theblood distribution in the LPV and RPV. There were84.24%cases ofvenous flow return from the SpV tends to be directed into the LPV anddrain into the left lobe of liver, and venous flow return from the SMVtends to be inflow into RPV and drain into the right lobe of liver. |
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