肝脏影像学检查在土三七引起的肝小静脉闭塞性疾病中的诊断价值  

Value of liver imaging scan in diagnosing hepatic veno-occlusive disease caused by Sedum Aizoon

作　　者：陈华忠[1] 邵辉[1] 耿才正[1] 吕计算 张智勤 

机构地区：[1]温州医学院附属台州医院,浙江临海317000 [2]仙居县人民医院,浙江仙居317300 [3]仙居县中医院,浙江仙居317300

出　　处：《临床肝胆病杂志》2012年第5期376-379,共4页Journal of Clinical Hepatology

基　　金：浙江省中医药科技计划基金资助项目(No.2010ZB160)

摘　　要：目的探讨肝脏影像学改变在肝小静脉闭塞性疾病(HVOD)患者诊断中的价值。方法对45例HVOD患者临床表现、肝脏影像学检查及肝穿刺组织学变化进行分析。结果 45例患者肝脏超声检查有28例患者可见"斑片状"或"豹纹状"低回声区;CT检查均有"地图状"密度改变,肝脏MRI T1WI均呈大片状低信号,T2WI信号呈略高信号,增强后呈"地图状"不均匀强化。肝脏超声诊断HVOD符合率62.2%(28/45);肝脏CT、MRI诊断HVOD符合率100%,二者差异有统计学意义(χ2=15.06,P<0.05)。21例作肝组织穿刺确诊的HVOD患者,检查均显示肝脏有"地图状"的高、低密度改变。结论肝脏CT、MRI诊断HVOD较肝脏超声检查有更高敏感性和特异性。肝脏CT、MRI可替代肝穿刺组织学检查诊断HVOD。Objective To investigate the liver imaging characteristics of acute and subacute hepatic veno-occlusive disease（HVOD）.Methods Clinical data of 45 cases who developed HVOD were collected and the clinical manifestation,imaging examination,histological examination of liver puncture biopsy,and the outcomes of changes were reviewed.Results 28 cases showed panther-stripe or patching low echogenic area of liver by ultrasonography.Map-like density changes was noticed in liver CT scan in all patients;Uniform signal intensity（SI） of liver showed in liver MR scan was big shape of low SI on TW1,slightly high SI on TW2,and map-like inhomogeneous enhancement.The diagnostic coincidence rates of HVOD were 100% on CT and MRI,as 62.2%（28/45）on ultrasonography.The difference between them was of statistical significance（χ2=15.06,P0.05）.Map-like density changes showed in the liver CT and MR scan of 21 cases which were made sure by histological examination of liver.Conclusion Liver CT and MRI scan had higher sensitivity and specificity than ultrasonography in the diagnosis of HVOD.HVOD can be diagnosed by liver CT and MRI scan instead of histological examination.

关 键 词：肝静脉闭塞性疾病 土三七 体层摄影术 螺旋计算机 磁共振成像 

分 类 号：R575[医药卫生—消化系统]