Value of 64-slice spiral CT in pediatric patients with primary cavernous transformation of portal vein

Objective To explore the value of 64-slice MSCT for primary cavernous transformation of portal vein(CTPV)in pediatric patients,and to observe clinical significances of MSCT classification of CTPV.Methods Clinical and 64-slice MSCT data of 37 children with idiopathic CTPV confirmed by surgery were retrospectively analyzed.All MSCT images were reconstructed with VR,MIP and MPR,then the characteristics of blood vessels were observed,and the patients were classified according to the range and site of CTPV.Results Thrombosis location,degree and collateral vessels were displayed in all patients.There were 8 cases of typeⅠCTPV(cavernous transformation only occurred on right and/or left branch of portal vein),18 cases of typeⅡ(cavernous transformation happened on both branches of portal vein and the main portal vein)and 11 cases of typeⅢ CTPV(typeⅡ accompanied with involvement of superior mesenteric vein and splenic vein).Liver transplantation was preferred in 3 cases of typeⅠCTPV.Among 18 cases of typeⅡ CTPV,portosystemic shunt was established in 15 cases,while accompanied splenectomy and pericardical devascularization were performed in 3 cases.Splenectomy and pericardical devascularization were also chosen for treatment of 8 patients with typeⅢ CTPV. Conclusion 64-slice MSCT is of vital importance in diagnosis of children with primary CTPV.MSCT classification of CTPV can provide important information for surgery operation and prognosis of primary CTPV in children.