Moody A R, Poon P Y
Department of Diagnostic Imaging, St. Michael's Hospital, Toronto, Ontario, Canada.
AJR Am J Roentgenol. 1992 Apr;158(4):779-83. doi: 10.2214/ajr.158.4.1546593.
The frequency with which gastroepiploic vein (GEV) enlargement was seen on CT and its relevance to disease of the portal venous system associated with pancreatic disease were studied. We performed a retrospective study of 50 patients with proved pancreatic disease and another 50 patients without such disease. The CT examinations were done in incremental dynamic fashion after a bolus injection of contrast medium. Scans were evaluated for collateral channel formation, including GEV enlargement, and for involvement of the portal venous system by pancreatic disease. Part of the GEV arcade was visible in 36 patients without pancreatic disease, and on average measured 3.2 mm in diameter (range, 1-5.5 mm). GEV enlargement was visible in 62% of the patients with disease; 16% demonstrated a vessel 6 mm or more in diameter. Thirty-four percent of the patients with disease had portal venous complications: 26% had isolated splenic vein involvement, 2% had isolated portal vein involvement, and 6% had a combination of splenic and portal vein involvement. Of the patients with splenic vein disease, 81% had collateral channel formation, 50% of them demonstrating isolated GEV enlargement. Patients with splenic vein disease due to acute pancreatic disease had a much higher instance of GEV enlargement (83.3%). Collateral vessels are commonly seen on CT scans of patients with splenic vein disease and most often occur via enlarged GEVs. Acute pancreatic disease is frequently associated with GEV enlargement, suggesting that the latter represents an early response to splenic vein disease. In contrast, multiple collateral pathways tend to develop in patients with chronic pancreatic disease.
研究了在CT上观察到胃网膜静脉（GEV）增粗的频率及其与胰腺疾病相关的门静脉系统疾病的相关性。我们对50例确诊为胰腺疾病的患者和另外50例无此类疾病的患者进行了回顾性研究。在静脉推注造影剂后以递增动态方式进行CT检查。评估扫描结果以确定侧支通道形成情况，包括GEV增粗，以及胰腺疾病对门静脉系统的累及情况。在36例无胰腺疾病的患者中可见部分GEV弓，其平均直径为3.2mm（范围为1-5.5mm）。62%的患病患者可见GEV增粗；16%的患者显示血管直径达6mm或更大。34%的患病患者有门静脉并发症：26%有孤立的脾静脉受累，2%有孤立的门静脉受累，6%有脾静脉和门静脉联合受累。在脾静脉疾病患者中，81%有侧支通道形成，其中50%表现为孤立的GEV增粗。急性胰腺疾病所致脾静脉疾病患者中GEV增粗的发生率更高（83.3%）。在脾静脉疾病患者的CT扫描中常见侧支血管，且最常通过增粗的GEV出现。急性胰腺疾病常与GEV增粗相关，提示后者是对脾静脉疾病的早期反应。相比之下，慢性胰腺疾病患者倾向于形成多条侧支途径。
