胃左静脉的多层螺旋CT评价对预测食管静脉曲张出血风险的价值  

Predictive value of multiple detector-row CT evaluation of the left gastric vein in esophageal variceal bleeding risk

作　　者：秦将均[1] 涂蓉[1] 巫北海[1] 俞安乐[1] 王正文[2] 伍保忠[1] 

机构地区：[1]海南医学院附属医院放射科,海南海口570102 [2]海南医学院附属医院普外科,海南海口570102

出　　处：《实用放射学杂志》2011年第9期1366-1369,共4页Journal of Practical Radiology

基　　金：海南省卫生厅课题（琼卫200556）.

摘　　要：目的 探讨64排螺旋CT门静脉成像（computed tomography portal venography,CTPV）显示胃左静脉对预测食管静脉曲张（esophageal varices,EV）出血风险的临床价值.方法 收集在本院经临床证实的40例肝硬化EV破裂出血的CTPV图像资料,并与40例同期肝硬化EV非出血组及80例正常对照的CTPV图像资料对照,分析胃左静脉直径与肝硬化EV破裂出血的关系.结果 EV出血组均见胃左静脉曲张增粗,伴有胃后、胃短静脉曲张增粗者19例;非出血组32例见胃左静脉曲张增粗,伴有胃后、胃短静脉曲张增粗者11例.肝硬化EV出血组：胃左 静脉直径范围为6.9～ 14.6 mm,平均为（8.67±1.96） mm;肝硬化EV非出血组：胃左静脉直径范围为5.3～12.0 mm,平均为（6.82±2.69） mm;正常对照组：胃左静脉直径范围为2.2～5.8 mm,平均为（4.10±1.86） mm.肝硬化出血组、非出血组、与正常组之间,胃左静脉直径差异有统计学意义（F=92.194,P〈0.000 1）,两两比较结果显示3组间差异均有统计学意义（P〈0.000 1）,肝硬化EV出血组胃左静脉直径最大,正常组最小.结论 胃左静脉的MDCT能较准确地预测肝硬化食管静脉曲张出血的风险情况,胃左静脉管径越宽,食管静脉曲张破裂出血危险性就越大.Objective To evaluate the clinical value of 64-detector row spiral computed tomography（MDCT） portal venography （CTPV） in showing the left gastric vein for predicting esophageal varices[EV} bleeding risk. Methods 40 patients with CTPV images , who suffered from hepatic cirrhosis esophageal varices bleeding and non-bleeding and 80 normals were collected , respectively. The CTPV images from the three groups were compared to analyze the relationship of left gastric vein diameter and liver cirrhosis EV bleeding. Results In EV bleeding groups ： the left gastric vein diameter ranged from 6.9 mm to 14.6 mm with average of （8.67±1.96 mm） ;EV non-bleeding group：the left gastric vein diameter ranged from 5.3 mm to 12.0 mm with average of （ 6.82± 2.69） mm; normal group： the left gastric vein diameter ranged from 2.2 ram to 5.8 mm with average of （4.10± 1.86） ram. Between cirrhosis bleeding group, non-bleeding group, and the normal group, the left gastric vein diameters were of significant differences（ F= 92. 194,P^0. 0001）. Pairwise comparisons among the three groups showed that there were significances [P% 0. 0001 }. The left gastric vein diameter was the biggest in liver cirrhosis EV bleeding group, and the smallest in the normal group. Conclusion MDCT of left gastric vein can accurately predict the risk of esophageal varices bleeding in the patients with cirrhosis. The wider the diameter of the left gastric vein, the greater the risk of esophageal varices bleeding.

关 键 词：体层摄影术 X线计算机 胃 食管静脉曲张 出血 

分 类 号：R814.42[医药卫生—影像医学与核医学] R573[医药卫生—放射医学]