门静脉CT血管成像评价肝硬化患者脾肾分流价值研究*

doi:10.3969/j.issn.1672-5069.2026.03.017

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 385-388.doi: 10.3969/j.issn.1672-5069.2026.03.017

门静脉CT血管成像评价肝硬化患者脾肾分流价值研究^*

魏鑫, 闫依嫚, 苏可婕, 王思怡, 徐鹏, 陈高红

221006 江苏省徐州市徐州医科大学附属医院医学影像科

收稿日期:2025-08-18 出版日期:2026-05-10 发布日期:2026-05-18
通讯作者: 陈高红,E-mail:xtchgh@sina.com
作者简介:魏鑫,女,25岁,硕士研究生。主要从事腹部影像学诊断研究。E-mail:1804738931@qq.com
基金资助:
^*江苏省高校基础科学(自然科学)研究项目(编号:21KJD320001)

CT portal venography in evaluating splenorenal shunt in patients with liver cirrhosis

Wei Xin, Yan Yiman, Su Kejie, et al

Department of Radiology, Affiliated Hospital, Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China

Received:2025-08-18 Online:2026-05-10 Published:2026-05-18

摘要/Abstract

摘要： 目的分析腹部CT增强扫描或门静脉CT血管成像(CTV)发现肝硬化患者脾肾分流(SSRS)发生情况。方法 2022年12月～2025年1月我院收治的131例肝硬化患者,均接受腹部CT增强扫描,采用多平面重组(MPR)、最大密度投影(MIP)和容积重建(VR)等后处理技术进行平面重建。结果在131例肝硬化患者中,发现SSRS者29例(22.1%);SSRS组食管胃底静脉曲张发生率、脾静脉直径和肠系膜上静脉直径分别为82.8%、(1.2±0.3)cm和(1.1±0.2)cm,均显著高于或大于无SSRS组【分别为62.7%、(1.0±0.3)cm和(0.9±0.2)cm,P<0.05】,而门静脉主干、左支和右支血管直径分别为(1.2±0.3)cm、(0.8±0.2)cm和(0.8±0.2)cm,均显著小于无SSRS组【分别为(1.4±0.3)cm、(1.0±0.3)cm和(0.9±0.2)cm,P<0.05】;多因素Logistic回归分析显示,脾静脉直径(OR<0.001)、门静脉主干直径(OR=0.003)、门静脉右支(OR=0.025)和肠系膜上静脉直径(OR=0.008)均为影响SSRS发生的独立危险因素。结论及时诊断肝硬化患者发生SSRS可能具有一定的临床意义,还需要深入研究。

关键词: 肝硬化, 脾肾分流, 门静脉, 脾静脉, 计算机断层扫描血管成像, 诊断

Abstract: Objective The aim of this study was to summarize the feature spontaneous splenorenal shunts (SSRS) diagnosed by abdominal contrast-enhanced CT scan and CT portal venography (CTV) in patients with liver cirrhosis (LC). Methods A total of 131 patients with LC were admitted to our hospital between December 2022 and January 2025, all patients underwent CT scan, and post-processed by multiplanar reconstruction,maximum intensity projection and volume reconstruction. Results Of the 131 patients with LC, SSRS was found in 29 cases (22.1%); incidence of esophagogastric varices, diameters of splenic vein and superior mesenteric vein in SSRS group were 82.8%, (1.2±0.3)cm and (1.1±0.2)cm, all significantly higher or greater than [62.7%, (1.0±0.3)cm and (0.9±0.2)cm, respectively, P<0.05], while diameters of main portal vein, left and right branches were (1.2±0.3)cm, (0.8±0.2)cm and (0.8±0.2)cm, all significantly smaller than [(1.4±0.3)cm, (1.0±0.3)cm and (0.9±0.2)cm, respectively, P<0.05] in non-SSRS group; multivariate Logistic regression analysis showed that diameter of splenic vein (OR<0.001), diameter of main portal vein (OR=0.003), diameter of right branch of portal vein (OR=0.025) and diameter of superior mesenteric vein (OR=0.008) were all the independent risk factors for SSRS occurrence. Conclusion CTV could help find SSRS existence in patients with LC, and its impact on clinical outcomes needs further investigation.

Key words: Liver cirrhosis, Spontaneous splenorenal shunts, CT portal venography, Portal vein, Splenic vein, Diagnosis

魏鑫, 闫依嫚, 苏可婕, 王思怡, 徐鹏, 陈高红. 门静脉CT血管成像评价肝硬化患者脾肾分流价值研究^*[J]. 实用肝脏病杂志, 2026, 29(3): 385-388.

Wei Xin, Yan Yiman, Su Kejie, et al. CT portal venography in evaluating splenorenal shunt in patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2026, 29(3): 385-388.

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门静脉CT血管成像评价肝硬化患者脾肾分流价值研究^*

CT portal venography in evaluating splenorenal shunt in patients with liver cirrhosis

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