肝硬化性脾动脉瘤的CT表现及其临床应用价值  

CT manifestations of splenic artery aneurysm associated with liver cirrhosis and its clinical value

作　　者：张笑春[1] 吴宗乾[1] 欧兰[1] 赵俊[1] 王健[1] 

机构地区：[1]第三军医大学西南医院放射科,重庆400038

出　　处：《实用放射学杂志》2015年第1期78-82,共5页Journal of Practical Radiology

摘　　要：目的：探讨肝硬化性脾动脉瘤（SAA）的 CT 表现及其与肝硬化病程关系。方法回顾性分析2024例肝硬化不合并肝癌患者,发现61例合并 SAA,对其临床及 CT 资料进行分析。结果肝硬化患者合并 SAA 的总发生率3.0%（女13.6%,男1.5%,门脉高压者9.3%,脾大者10.2%）。CT 显示 SAA 常多发,主瘤体多位于脾动脉主干中远段、直径多＆gt;1.0 cm、多呈圆形,小 SAA 多位于脾动脉分支、直径多≤1.0 cm、多呈梭形（P =0.000）。随着肝硬化病程的延长,主瘤体位于脾动脉近端增多、直径增大,分支瘤体数量增多,且瘤壁钙化、瘤周血肿、瘤腔内附壁血栓、巨脾/脾梗死和曲张静脉团的发生率增高（P =0.000）。结论女性、伴有门脉高压和脾大的肝硬化患者 SAA 发生率高。CT 能够清晰显示 SAA 的好发部位、数量、大小、形态、瘤体合并征象及门脉高压相关征象,SAA 的 CT 表现与肝硬化病程密切相关,为治疗方式选择提供指导。Objective To explore the CT manifestations of splenic artery aneurysm （SAA）in patients with liver cirrhosis,and its relationship with degree of cirrhosis.Methods SAA in 61 patients were confirmed from total 2 024 patients with liver cirrhosis but without hepatoma,and the clinic and CT data were retrospectively analyzed.Results SAA incidence rate of 3.0% （13.6% of women,1.5% of men,9.3% of portal hypertension and 10.2% of hypersplenotrophy）was observed in patients with liver cirrhosis. Multiple SAAs usually were showed with large round lesions （＆gt;1.0 cm）in the middle and distal segment of splenic artery and small fusiform ones （≤1.0 cm）in the branches of splenic artery （P =0.000）.With the gradual deterioration of cirrhosis produce,the number and size of large aneurysms in proximal segment of splenic artery and number of small ones were increased with more inci-dence rates of calcification of aneurysm wall,haematoma of peri-aneurysm,mural thrombosis in SAA,megalosplenia/infarction of spleen and phlebeurysma （P =0.000）.Conclusion Higher incidence rate of SAA in female patients with liver cirrhosis,portal hy-pertension and hypersplenotrophy is observed.CT can show well the location,number,size,shape and other features of SAA and portal hypertension,CT findings are correlated with the degree of cirrhosis,which may help for the treatment.

关 键 词：肝硬化 脾动脉瘤 计算机体层成像 

分 类 号：R575.2[医药卫生—消化系统] R733.2[医药卫生—内科学]