螺旋CT三期扫描对肝纤维化诊断价值研究  

The Study on the Diagnostic Value of Spiral CT Three-phase Scan in Hepatic Fibrosis

作　　者：陆健 王鸿帼[2] 张涛[1] 程斌[1] 沈继明[1] 胡振民[2] 施裕新[2] 赵云[1] 徐建忠[1] 顾春燕[1] 

机构地区：[1]南通市第三人民医院影像科,江苏南通226006 [2]南通大学附属医院影像科

出　　处：《实用放射学杂志》2006年第9期1075-1078,共4页Journal of Practical Radiology

摘　　要：目的探讨螺旋CT三期扫描对肝纤维化的诊断价值。方法对66例经肝穿刺活检病理证实的慢性乙型肝炎肝纤维化患者组和42例正常对照组进行螺旋CT三期增强扫描。根据纤维化程度分期进行影像资料和相关指标的统计分析。结果肝左叶增大,肝表面形态及肝实质密度的改变,脾脏增大,门静脉增宽和侧枝循环的建立等影像学改变,随着肝纤维化严重程度的加重而有统计学差异。本研究显示57例肝纤维化患者螺旋CT三期扫描诊断肝纤维化52例,敏感性91.2%,特异性77.8%。各期肝纤维化分期准确28例,准确率49.1%;准确判断轻度纤维化(S1、S2)或重度纤维化(S3、S4)44例,准确率77.2%,诊断早期肝硬化16例,准确率84.2%。结论螺旋CT三期扫描能判断肝纤维化的程度,而且是动态观察肝纤维化的病程演进和临床随访的有效手段。Objective To appraise the value of spiral CT three - phase scan in diagnosis of hepatic fibrosis. Methods Spiral CT three - phase scan was performed in 66 patients with chronic hepatitis confirmed pathologically by liver biopsies and the 42 healthy. The imaging data and related parameters were statistically analyzed according to the staging of hepatic fibrosis. Results The changes including the size of hepatic left lobe,hepatic surface contours and parenchymal density,splenomegaly, widened and conllaterals of portal vein were serious with the severity of hepatic fibrosis enhanced,which were of statistical significance. 52 of 57 patients with hepatic fibrosis were confirmed by spiral CT three - phase scan, the sensitivity was 91.2% and the speciality was 77.8%. 28 were correctly staged （49.1% ） ,44 were correctly diagnosed as S1 ,S2 or S3,S4,the veracity was 77.2% ,16 patients with early hepatocirrhosis were diagnosed,the veracity was 84.2%. Conclusion The non - invasive spiral CT three - phase scan is valuable in diagnosis of hepatic fibrosis. It is a valuable tool for dynamic observations of he- patic fibrosis during its progression and clinical follow - up.

关 键 词：肝脏 肝纤维化 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]