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中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2022, Vol. 12 ›› Issue (05) : 302 -305. doi: 10.3877/cma.j.issn.2095-2015.2022.05.011

综述

影像融合技术在经颈静脉肝内门体分流术门静脉穿刺引导中的应用进展
胡锦华1,†(), 李涛1, 崔屹1, 张春清1   
  1. 1. 250021　济南，山东第一医科大学附属省立医院消化内科
  • 收稿日期:2021-02-06 出版日期:2022-10-01
  • 通信作者: 胡锦华

Application progress of image fusion technique in portal vein puncture guidance in Transjugular intrahepatic portosystemic shunt

Jinhua Hu1,†(), Tao Li1, Yi Cui1, Chunqing Zhang1   

  1. 1. Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
  • Received:2021-02-06 Published:2022-10-01
  • Corresponding author: Jinhua Hu
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胡锦华, 李涛, 崔屹, 张春清. 影像融合技术在经颈静脉肝内门体分流术门静脉穿刺引导中的应用进展[J]. 中华消化病与影像杂志(电子版), 2022, 12(05): 302-305.

Jinhua Hu, Tao Li, Yi Cui, Chunqing Zhang. Application progress of image fusion technique in portal vein puncture guidance in Transjugular intrahepatic portosystemic shunt[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2022, 12(05): 302-305.

经颈静脉肝内门体分流术是治疗肝硬化食管胃底静脉曲张和顽固性腹水的常用微创介入技术，目前门静脉穿刺仍是该手术操作的难点和瓶颈。门静脉的反复穿刺，可能导致围手术期严重并发症，甚至死亡。传统上静脉穿刺基本上是在透视下经验性穿刺，有一定盲目性，且严重依赖于术者的经验；为了减少穿刺次数和优化准确性，临床上出现了多种穿刺引导技术，包括直接门静脉穿刺标记，CO2门静脉造影标记，实时床旁超声引导，以及图像融合辅助。众多不同穿刺引导技术各有优势和不足，并在实践中不断演化，其中，图像融合技术的潜力逐步得以释放，一定会使门静脉穿刺引导更加智能、直观、简洁，使经颈静脉门体分流术更安全，本文对此技术的进展进行了归纳整理。

关键词: 经颈静脉肝内门体分流术, 影像融合, 门静脉穿刺

Transjugular intrahepatic portosystemic shunt (TIPS) is a common minimally invasive interventional technique for the treatment of liver cirrhosis patients with esophagus and gastric varices and intractable ascites. At present, portal vein puncture is still the difficulty and bottleneck of the operation. Repeated puncture of portal vein may lead to serious complications or even death during perioperative period. Traditionally, vein puncture is an experiential puncture under fluoroscopy, which is blind to some extent and depends heavily on the experience of the operators. In order to reduce the number of puncture times and optimize the accuracy, a variety of puncture guidance techniques have emerged in clinical practice, including direct portal vein puncture marker, CO2 portal venography marker, real-time bedside ultrasound guidance, and image fusion assistance. These puncture guidance techniques have their own advantages and disadvantages and are evolving in practice. Among them, the potential of image fusion technology is gradually released, which makes portal vein puncture guidance more intelligent, intuitive and concise, and makes TIPS safer. This paper summarizes the progress of this technique.

Key words: Transjugular intrahepatic portosystemic shunt, Image fusion, Portal vein puncture
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