Matsumoto Tomohiro, Yamagami Takuji, Terayama Koshi, Kato Takeharu, Hirota Tatsuya, Yoshimatsu Rika, Miura Hiroshi, Ito Hirotoshi, Okanoue Takeshi, Nishimura Tsunehiko
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto, Japan.
Acta Radiol. 2009 Jul;50(6):617-23. doi: 10.1080/02841850902922779.
Although portal and/or splenic vein thrombosis after partial splenic embolization (PSE) is a well-known complication, few reports evaluating risk factors have been published.
To investigate risk factors and clinical course of portal and/or splenic vein thrombosis after PSE.
Sixteen patients with severe hypersplenism underwent PSE between March 2005 and April 2008. The correlation between portal and/or splenic vein thrombosis after PSE detected on multidetector row CT (MDCT) and various factors were retrospectively reviewed. Further, the clinical course of portal and/or splenic vein thrombosis after PSE was observed on follow-up MDCT.
Splenic vein thrombosis was detected in eight patients (50%) on MDCT images taken within 9 days after PSE. In one, the thrombosis also involved the portal vein. The infarct volume was identified as a significant risk factor for portal and/or splenic vein thrombosis (P=0.046). In all but one patient, splenic vein thrombosis resolved completely or improved without anticoagulation therapy. In this patient, both portal and splenic vein thrombosis developed after PSE, and anticoagulation therapy was necessary.
It is suggested that a large splenic infarct volume is a risk factor for portal and/or splenic vein thrombosis after PSE. Indications for treatment of thrombosis of the portal vein system after PSE may be limited to patients with portal vein thrombosis.
尽管部分脾栓塞术（PSE）后门静脉和/或脾静脉血栓形成是一种众所周知的并发症，但评估危险因素的报道很少。
探讨PSE后门静脉和/或脾静脉血栓形成的危险因素及临床过程。
2005年3月至2008年4月期间，16例严重脾功能亢进患者接受了PSE。回顾性分析多排螺旋CT（MDCT）检测到的PSE后门静脉和/或脾静脉血栓形成与各种因素之间的相关性。此外，在随访MDCT上观察PSE后门静脉和/或脾静脉血栓形成的临床过程。
在PSE后9天内拍摄的MDCT图像上，8例患者（50%）检测到脾静脉血栓形成。其中1例血栓也累及门静脉。梗死体积被确定为门静脉和/或脾静脉血栓形成的一个重要危险因素（P=0.046）。除1例患者外，所有患者的脾静脉血栓形成在未进行抗凝治疗的情况下完全消退或改善。在该患者中，PSE后同时发生门静脉和脾静脉血栓形成，需要进行抗凝治疗。
提示脾梗死体积大是PSE后门静脉和/或脾静脉血栓形成的危险因素。PSE后门静脉系统血栓形成的治疗指征可能仅限于门静脉血栓形成的患者。
