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目的 探讨磁共振血管成像(MRA)在经颈静脉肝内门腔分流术(TIPS)前检查中的作用.资料与方法 对59例拟行TIPS治疗的患者行术前MRA检查,观察引起门静脉高压的病因、肝静脉及门静脉形态、走行,并测量穿刺点处血管管径.结果肝硬化49例、肝硬化合并肝癌4例、门静脉血栓3例、脾静脉狭窄1例、布-加综合征2例;肝静脉分型:三支型占24.6%、两支型占68.4%、一支型占7.0%.肝右静脉、肝中静脉、肝左静脉穿刺点管径符合率分别为91.2%、70.1%、49.1%;门静脉右支和左支安全穿刺点分别位于(14.7±4.2)mm、(12.4 ±5.3)mm以远.结论 动态增强MRA(DCE MRA)是一种有价值无损伤的检查方法 ,对TIPS术前疾病诊断及血管定位有着重要的意义.“,”Objective To explore the role of MRA in the evaluation of vascular puncture sites before TIPS.Materials and Methods 59 cases were examined with preoperative MRA examination to observe the cause of portal hypertension,the patterns and shapes of liver and portal vein.The diameter of puncture site were measured on MRA.Results There were 49 cases of liver cirrhosis ,4 cases of liver cirrhosis with bepatocellular carcinoma,3 cases of portal vein thrombosis,1 cases of splenic vein stenosis,2 eases of Budd Chiari in this study.Hepatic veins showed 3 types:type 1 24.6% ,type Ⅱ168.4%,type III7.0%.The rates of vein diameter which can be punctured of fight hepatic vein,middle hepatic vein,left hepatic points were 91.2% ,70.1% ,49.1%.The safety puncture sites of the right branch of portal vein and left branch of portal vein were (14.7±4.2) mm and (12.4±5.3) mm.Conclusion MRA is a valuable non invasive method and take great role in diagnosis and assessment of vascular puncture sites before TIPS.