| 邓黎严琰,陈勇,叶鹏,缪洪飞,马硕一,曾庆乐.经TIPS途径造影观察肝硬化门静脉高压失代偿期患者门体静脉侧支血管[J].中国介入影像与治疗学,2019,16(11):657-661 |
| 经TIPS途径造影观察肝硬化门静脉高压失代偿期患者门体静脉侧支血管 |
| Observation on portosystemic collateral vessels with catheterizing in portal vein directly through TIPS in decompensated cirrhotic portal hypertension patients |
| 投稿时间：2019-05-10 修订日期：2019-07-01 |
| DOI：10.13929/j.1672-8475.201905019 |
| 中文关键词: 肝硬化 门静脉高压 失代偿期 侧支血管 血管造影术 数字减影 |
| 英文关键词:liver cirrhosis portal hypertension decompensated stage collateral vessels angiography digital subtraction |
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| 中文摘要: |
| 目的 探讨经TIPS途径门静脉属支置管造影观察肝硬化门静脉高压失代偿期（DCPH）门体静脉间侧支血管（PSCV）的可行性及其造影表现。方法 回顾性分析经临床确诊为DCPH并接受TIPS治疗的274例患者的资料。术中均经TIPS途径置管至肠系膜上静脉和脾静脉，行门静脉DSA造影。基于造影表现，对PSCV进行分类，并描述其特点。结果 对274例患者均成功完成TIPS治疗及门静脉属支造影，根据PSCV在门静脉系统的起源部位，可将其分为4种类型：①门静脉分支型，占2.55%（7/274），为向肝血流且以分流为主；②门静脉主干型，占23.36%（64/274），为离肝血流且血流量较大；③门静脉属支型，占12.77%（35/274），为离肝血流且汇入体循环的途径较多；④混合型，占61.31%（168/274），为门静脉系多起源参与PSCV供血。结论 经TIPS途径对DCPH患者进行门静脉属支置管DSA造影安全、可行，可显示PSCV的起源及其分型。各型PSCV具有不同的血流动力学特点。 |
| 英文摘要: |
| Objective To investigate the DSA manifestations of the portosystemic collateral vessels (PSCV) in the patients with decompensated cirrhotic portal hypertension (DCPH) and the feasibility of portovenography performed with catheterizing in the portal vein directly through TIPS. Methods Totally 274 patients with DCPH who were treated with TIPS were enrolled and retrospectively analyzed. DSA was directly performed with catheterizing in the superior mesenteric vein and splenic vein through TIPS, respectively. DSA manifestations of PSCV were observed and described. And PSCV were classified based on the manifestations. Results All 274 patients were successfully treated with portal vein angiography and TIPS, and no postoperative complications occurred. According to the origin, PSCV could be classified into four types, including branch of portal vein type (2.55%[7/274]), which were blood to hepatic and mainly by shunt; main portal vein type (23.36%[64/274]), which were blood leaving hepatic with large blood flow; tributaries of the portal vein type (12.77%[35/274]), which were blood leaving hepatic with various ways to systemic circulation; multi-sources type (61.31%[168/274]), which were supplied by multiple origins. Conclusion Direct portovenography through TIPS is safe and feasible,which can display classification of PSCV, including branch of portal vein type, main portal vein type, tributaries of portal vein type and multi-sources type, all having different hemodynamic characteristics. |
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