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经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)是在肝静脉和门静脉之间创建肝内分流通道,有效控制肝硬化门静脉高压所致并发症的微创治疗方法。术前准确判断肝硬化Child-Pugh分级及肝脏储备功能,发现肝内变异血管,观察肝静脉和门静脉形态走行及测量两者间距离,了解肝血管有无狭窄、有无血栓形成,对决定是否能行TIPS术、TIPS治疗方案的制定及减少术后并发症、判断手术预后有重要意义。目前多种影像学检查用于TIPS术前肝硬化Child-Pugh分级及肝血管的评估,在本文中作者对肝硬化门静脉高压患者TIPS术前影像学评估进行综述。
Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive treatment that creates an intrahepatic shunt pathway between the hepatic vein and portal vein and effectively controls the complications caused by cirrhotic portal hypertension. Preoperative diagnosis of liver cirrhosis Child-Pugh grading and liver reserve function, found that intrahepatic vascular variability, observe the morphology of the hepatic veins and portal vein walk and measure the distance between the two, to understand whether the hepatic vessels stenosis, with or without thrombosis, the decision whether To TIPS surgery, TIPS treatment plan to develop and reduce postoperative complications, to determine the prognosis of surgery is of great significance. At present, a variety of imaging studies are used to evaluate the Child-Pugh classification of liver cirrhosis and hepatic vessels in TIPS. The author reviews the preoperative TIPS imaging of patients with cirrhosis and portal hypertension.