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Portal vein lesions in the past to use more CTAP portal vein angiography is an invasive (patients receiving radiation quantity and operating technical complexity). 64-slice spiral CT angiography of the hepatic portal vein advantages: scanning range and spatial resolution imaging of blood vessels in the portal vein can be optimized simultaneously, in a short period of time longer range volume scanning through the image layer thickness and spacing TLC rebuilt, can extend the scan time and without increasing the contrast agent in the case of revascularization higher quality images. Multislice CT portography can be displayed in full normal and variant of portal venous system anatomy, visually evaluate their position, contour, non-invasive, rapid, economical and multi-angle observation of blood vessels and the benefits and 64-slice spiral CT in time after contrast injection to be completed multi-stage liver scans, including the hepatic artery (MSCTA) and portal vein (MSCTP); utilization in the data, CTP while to get the full circumstances and liver parenchyma evidence of intra-abdominal lesions. At present, about 64 rows of scanning technology MSCTP few studies, this study using different concentrations of contrast medium, the injection flow rate and scan delay time selected for preliminary study. A pre-injection test 64-slice spiral CT hepatic portal vein imaging delay time select a destination: Through a small dose of pre-injection experimental method to obtain different contrast agent injection rates and different contrast agent concentration in the 64-slice spiral CT hepatic portal vein imaging delay time . And compare each group Portography image quality. Materials and Methods: 1, randomly selected from 2007.4-2007.6 volunteers without severe heart, liver disease, 45 cases were randomly divided into three groups, according to different rates of contrast injection into A (3ml / s), B (4ml / s) , C (5ml / s) three groups, each group of 15 cases. All subjects caught before scanning oral 500-1000ml of water filling the gastrointestinal tract, take the first foot position, using 64-slice GE Light speed VCT machine unenhanced, take portal vein level, being at the same level for dynamic continuous scanning, and by double cylinder pressure syringe antecubital vein bolus injection of nonionic contrast agent Omnipaque (300mg/ml) 15-20ml, each group delay 25s, scan interval 1s, scan time 1s, a total of 15 layers. In the obtained image placement portal vein ROI area, have time to go out vein - density curve obtained portal vein CT peak value of the optimal delay time; further injection of contrast agent 70-80ml, According to the information backwards in time delay 3-5S scan, scan range from the top to the waist three vertebrae diaphragmatic level; thin built after the original data transmitted GE Advantage Workstation4.3 workstation MIP, VR post-processing. Portal vein in each group reach the peak time of the CT value difference, evaluated at different flow rates of portal vein imaging quality. Statistical analysis using SPSS11.5 software (ANOVA). 2, on the basis of the above study, healthy volunteers choose 2007,07-11 months, 90 patients at different concentrations of contrast agent injection of contrast medium flow rate divided 1 (3ml / s), 2 (4ml / s) groups, each group concentration were divided into D1, D2 group (300mgI/mL), E1, E2 group (350mgI/mL), F1, F2 group (370mgI/mL). wherein D1, D2 corresponding to the previous group A and B of the test group group, 15 cases in each group. Applying the same scan, post-processing and statistical analysis of comparative study of different concentrations of contrast agent portal vein peak delay time and a reasonable choice of image quality. Results: 1, A group (3mL / s) portal vein peak average time is about 42s, B group (4mL / s) peak average time is about 33s, C group (5mL / s) peak average time is about 29s. A, B, C three groups reached its peak when the portal vein mean CT values ??of approximately 202.09Hu, 215.87Hu, 243.16Hu, statistical analysis P> 0.05 was not statistically significant. 2, D1, E1, F1 group, the average time to peak portal vein were approximately 42s, 43s, 50s, D2, E2, F2 group portal vein peak time was 33s, 34s, 44s. 3, D1, D2, E1, E2, F1, F2 six groups of portal vein during peak mean CT values ??were 202.09Hu, 215.87Hu, 214.24Hu, 219.70Hu, 219.43Hu, 224.08Hu, each group reached a peak of portal vein CT value when the difference was not statistically significant (P> 0.05). Conclusion: According to the results obtained when the contrast agent is 300mgI/mL to 3mL / s or 4mL / s flow rate of injection timing, respectively, the average delay of about 42s, 33s, when the contrast agent is 300mgI/mL to 3mL / s or 4mL / s injection flow rate, the average delay time of selection were approximately 43s, 34s, when the contrast agent is 370mgI/mL to 3mL / s or 4mL / s flow rate of injection timing, respectively, the average delay in 50s, 44s , 64-slice spiral CTP scan backwards in time delay 3 ~ 5s can get a better picture, you can display more than five branches, basically meet the clinical needs. Second, the 64-slice spiral CT hepatic portal vein imaging clinical applications Objective: To study 64-slice spiral CT portal vein to the liver normal anatomy and variation of clinical application value to explore 64-slice spiral CT liver, pancreas Ministry common manifestation of vascular lesions. MATERIALS AND METHODS: CT enhanced scan without any contraindications and clinical suspicious liver, pancreas lesions of 40 patients underwent MSCTP checked before scanning oral water filling the gastrointestinal tract, the scan obtained after completion of the reconstruction of the original data sheet and returns to Advantage Workstation4.3 workstation MIP, VR reconstruction. Results: 12 patients with portal hypertension: the performance of vascular uneven thickness, portal vein, splenic vein significantly enlarged, intrahepatic portal vein branches show 3 to 4, formation of collateral circulation; 7 patients with benign liver lesions: Performance Traveling to the portal vein natural and normal portal vein were similar to lesions larger hepatic portal vein compression goes on, but the vessel edge finishing; liver Ca 15 patients: the performance of portal vein compression, displacement, diameter thinning, branch scarce , portal vein and its branches invaded the edges blur, which portal vein tumor thrombus in 9 cases, portal vein see the contrast agent filling defect; pancreas Ca 6 patients, including one case involving the portal vein, four cases of superior mesenteric vein involvement, and lesion boundaries unclear, one case of pancreatic body and tail tumors not involving the portal vein. Conclusion: 64-slice spiral CT angiography in the portal vein, portal vein can clearly show the normal anatomy and variants, can clearly show the liver, pancreas lesions of the portal vein and tumor, whether the degree of invasion and invasion, surgical and interventional treatment for clinical , liver transplantation provides important information, has broad clinical application.
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