多排螺旋CT扫描评估食管静脉曲张  

Multi--slice Spiral CT Evaluation of Esophageal Varices in Cirrhosis

作　　者：徐骁[1] 冯琦[1] 杨咏琰[1] 华佳[1] 许建荣[1] 顾海燕[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127

出　　处：《实用放射学杂志》2010年第7期970-972,985,共4页Journal of Practical Radiology

基　　金：上海市重点学科建设资助项目（S30203）.

摘　　要：目的 评价多排螺旋CT扫描对肝硬化病人食管静脉曲张程度进行评估的可行性. 方法 40例肝硬化病人在4周内分别完成内镜和上腹部CT增强扫描检查,分析每位病人的CT图像,对食管静脉曲张程度进行分级,并将结果与内镜比较.对于存在食管静脉曲张的病例,测量其曲张静脉的最大直径.结果 利用增强CT评估食管静脉曲张程度的敏感性为94%,特异性为71%,准确率为67.5%, 其与内镜对食管静脉曲张程度评估结果没有显著差异（P〉0.05）;对于中度以上食管静脉曲张病人,CT测得的曲张静脉范围为2.37～8.73 mm,平均（4.66±1.77） mm, 95%可信区间为3.88 mm,5.45 mm,即曲张血管直径≥3.88 mm时,可以判断其存在中度以上食管静脉曲张.结论 CT增强扫描是发现和评估肝硬化病人食管静脉曲张程度的有效手段.Objective To evaluate the feasibility of multi--slice spiral CT （MSCT）in the detection and grading of esophageal varices in cirrhosis. Methods 40 consecutive cirrhotic patients who underwent both upper endoscopy and enhanced epigastric CT scan- ning within 4 week interval were evaluated. All images were interpreted to detect the presence of esophageal varices and its degree, the diameter of largest variees was measured. Results The accuracy, sensitivity and specificity were 67.5%, 94 % and 71%, respectively in detecting varices with CT. There was no difference between CT and endoscopy in esophageal variceal grading[ P^0.05）. For patients suffering from moderate or severe esophageal variees, the average diameter of varices measured on contrast--enhanced CT images was （4.66±1.77）mm （ranged 2.37 to 8.73 mm） and 95% confidence interval was 3.88 to 5.45mm, which indicated that moderate or severe esophageal varices might be diagnosed when the diameter of varices was 3. 88 mm or more. Conclusion MSCT is a feasible and useful method for detecting and grading esophageal varices.

关 键 词：肝脏 肝硬化 食管静脉曲张 体层摄影术 X线计算机 

分 类 号：R575.2[医药卫生—消化系统] R571[医药卫生—内科学]