The Value Of 128 Slice Spiral CT Portal Vein Imaging In Evaluation Splenorenal Shunt

ObjectiveThe study is to explore the incidence and common type of the splenorenal shunt collateral circulation in patients with portal hypertension through portal vein imaging by128 slice spiral CT,and to study the correlation between the incidence of the splenorenal shunt collateral circulation with portal hypertension and severity and rupture bleeding of esophagus veins varices,and then more accurately to evaluate the application value of splenorenal shunt in clinical diagnosis and treatment.MethodsBetween December 2014 and November 2015,146 patients who suffered from liver cirrhosis and were treated were recruited in our hospital for the present study.All the patients underwent abdominal three phase dynamic enhanced scan,maximum intensity projection,multi level recombination,and volume imaging by 128 slice spiral CT.The patients were divided into either the A with splenorenal shunt or B without.Average diameters of the portal vein,the splenic vein and the left renal vein,and the incidence and severity of esophageal varices were expressed.All data were analyzed using the x²test,single factor variance analysis and Pearson correlation x ² test with statistical software of SPSS 17.0 for windows.Results40 patients were included in group A,and 106 in group B.The occurrence rate of splenorenal shunt is about 27.4%;The diameters of portal vein in group A?17.87±4.23mm?were little different from those in group B?17.72±4.59mm?.There was no significant statistical difference in the two groups?F=0.04,P=0.843?;The diameters of spleen vein in group A?14.74±4.53mm?were higher than those in group B?12.64±3.66mm?.There was significant statistical difference in the two groups?F=10.275,P=0.002?;The diameters of spleen vein diameter in group A?13.03±4.67mm?were higher than those in group B?10.80±3.80mm?.There was significant statistical difference in the two groups?F=10.501,P=0.002?;The incidence of esophageal varicose in the two groups were 65%and 81%respectly;There was significant difference in the two groups(x²=4.23>x ²_0.05,1=3.84,P<0.05);The patients with esophageal varices was divided into 3 level,incidence of all levels in two groups was respectively?46%,35%,19%?,and?28.0%,32.5%,39.5%?;There was significant statistical difference in the two groups(x²=6.24>x²_0.05,2=5.99,P<0.05);There was some certain correlation between the happen of splenorenal shunt and portal hypertension,severity and incidence of esophageal varices?P=0.01<0.05?.ConclusionThe splenorenal shunt is one of common collateral circulation in patents with portal hypertension.There was no certain correlation between the presence of splenorenal shunt and the diameters of the portal vein.There was significant correlation between the presence of splenorenal shunt and the diameters of the splenic vein and left renal vein.The diameters in group A were higher than these in group B,meaning that diameter width of the spleen vein and the left renal vein can indicate whether there is splenorenal shunt someti mes.There is certain correlation between incidence of splenorenal shunt and incidence and servity of esophageal varices.The incidence of splenorenal shunt can relieve incidence and servity of esophageal varices.The value of spontaneous splenorenal shunt should be pay attention to in the treatment of patients with cirrhosisin.