Department of Nuclear Medicine, Qilu Hospital of Shandong University, Jinan 250012, China.
J Nucl Med. 2010 Jan;51(1):52-6. doi: 10.2967/jnumed.109.067983. Epub 2009 Dec 15.
Our objective was to investigate the diagnostic value and clinical significance of transsplenic portal scintigraphy in cirrhotic portal hypertension and compensatory circulation.
Transsplenic portal scintigraphy, ultrasound, and gastroscopy were performed on 50 patients with cirrhotic portal hypertension and on 10 controls. According to the Child-Pugh classification, 15 patients with cirrhosis were Child A, 19 were Child B, and 16 were Child C.
In the control group, the splenoportal vein was shaped like the letter S, and the portosystemic shunt index was 0.19 +/- 0.07. Portal hypertension portosystemic shunts were of 3 types: intrahepatic (13 patients; index, 0.52 +/- 0.19), compensatory (31 patients; index, 0.64 +/- 0.28); and completely extrahepatic (6 patients; index, 0.91 +/- 0.03). Collateral vessels were uphill, downhill, or complex. The portosystemic shunt index increased as cirrhosis and esophageal varices increased. There was statistical significance among groups (P < 0.05 or < 0.01).
Transsplenic portal scintigraphy was sensitive for detecting the number and location of shunts and will allow for improved surgical planning.
探讨经脾门静脉闪烁照相在肝硬化门脉高压症及侧支循环中的诊断价值及临床意义。
对 50 例肝硬化门脉高压症患者及 10 例对照者进行经脾门静脉闪烁照相、超声和胃镜检查。根据 Child-Pugh 分级，15 例肝硬化患者为 Child A，19 例为 Child B，16 例为 Child C。
对照组脾门静脉呈 S 形，门体分流指数为 0.19±0.07。门脉高压性门体分流有 3 种类型：肝内型（13 例；指数为 0.52±0.19）、代偿型（31 例；指数为 0.64±0.28）和完全肝外型（6 例；指数为 0.91±0.03）。侧支循环为上行、下行或混合。门体分流指数随肝硬化及食管静脉曲张程度的增加而增加。各组间差异有统计学意义（P<0.05 或<0.01）。
经脾门静脉闪烁照相术对检测分流的数量和部位敏感，有助于改善手术计划。
