Department of Hepatobiliary Surgery, Children's hospital, Chongqing Medical University, Chongqing 400014, China.
World J Gastroenterol. 2011 Oct 14;17(38):4334-8. doi: 10.3748/wjg.v17.i38.4334.
To investigate the role of 64-slice computed tomography (CT) in portal vein cavernous transformation to determine surgical strategy.
The site of lesions and extent of collateral circulation in 12 pediatric cases of cavernous transformation of the portal vein with surgical treatment were analyzed.
Eleven of 12 children had esophageal varices and were treated with lower esophageal and gastric devascularization and splenectomy, and the other case was only treated with splenectomy. There were eight cases with spontaneous spleen/stomach-renal shunt, four with Retzius vein opening, which was reserved during surgery. Three cases of lesions involving the intrahepatic portal vein (PV) were treated with living donor liver transplantation. One patient died from PV thrombosis after liver transplantation, and the rest had no significant complications.
The PV, its branches and collateral circulation were clearly seen by 64-slice spiral CT angiography, which helped with preoperative surgical planning.
探讨 64 层螺旋 CT 在门静脉海绵样变性中的作用，以确定手术策略。
对 12 例手术治疗的门静脉海绵样变性患儿的病变部位和侧支循环程度进行分析。
12 例患儿中 11 例有食管静脉曲张，行食管胃底静脉离断和脾切除术，另 1 例仅行脾切除术。8 例有自发性脾肾分流，4 例有 Retzius 静脉开放，术中保留。3 例累及肝内门静脉（PV）的病变采用活体肝移植治疗。1 例患者在肝移植后出现门静脉血栓形成，死亡，其余患者无明显并发症。
64 层螺旋 CT 门静脉血管成像可清晰显示门静脉及其分支和侧支循环，有助于术前手术规划。
