CT动态增强扫描诊断肝窦阻塞综合征的临床价值及意义  

Clinical value and significance of dynamic enhanced CT in diagnosis of hepatic sinusoidal obstructive syndrome

作　　者：孙慧芳[1] 张慧宇[1] 丁昌懋[1] 王博[1] 高剑波[1] 

机构地区：[1]郑州大学第一附属医院放射科,河南450052

出　　处：《肝脏》2016年第6期438-440,共3页Chinese Hepatology

摘　　要：目的探讨CT动态增强扫描对肝窦阻塞综合征(HSOS)的诊断价值。方法纳入经活组织检查及影像学确诊的HSOS、布-加综合征(BCS)及肝硬化患者51例,分别利用CT动态增强扫描结果、巴尔的摩标准再次诊断HSOS,对比两者诊断效果。结果 HSOS的典型CT表现包括CT平扫呈肝大、密度减低;增强扫描动脉期可见肝动脉血管增粗扭曲;门静脉期呈"地图状"改变、肝静脉不清、下腔静脉及门静脉呈"晕征"或"轨道征"、下腔静脉肝段扁平等;延迟期强化范围增大。CT对HSOS的诊断敏感性0.857,优于巴尔的摩标性0.500,CT对HSOS诊断特异性0.811,差于巴尔的摩标准0.946。CT与巴尔的摩标准对HSOS的诊断准确率接近,差异无统计学意义(P>0.05)。结论早期诊断HSOS时,CT动态增强扫描是巴尔的摩标准的有力补充。Objective To investigate the value of dynamic enhanced computed tomography （CT ） in diagnosis of hepatic sinusoidal obstructive syndrome （HSOS ） .Methods Fifty‐one patients definitely diagnosed with HSOS ,Budd‐Chiari syndrome （BCS） and liver cirrhosis by biopsy or imaging were retrospectively analyzed .Dynamic enhanced CT and Baltimore standard were performed in these patients respectively ,and comparisons were conducted .Results In HSOS patients ,hepatomegaly and hypodensity were observed in non‐contrastive CT scan .In terms of arterial phase on dynamic enhanced CT ,it showed dilated and tortuous hepatic artery .And on the portal venous phase ,it showed map‐shaped change ,unclear hepatic vein ,inferior vena cava ,portal vein with halo sign or track sign ,flat inferior vena cava in the liver section ,and etc .Additionally ,enhanced range increased during delay period .In diagnosis of HSOS ,CT was more sensitive than Baltimore standard （0 .857 vs .0 .500） ,but less specific than Baltimore （0 .811 vs .0 .946） .Diagnostic accuracy of CT and Baltimore standard for HSOS was similar ,which showed no statistically significant differences （P 〉 0 .05） .Conclusion In early diagnosis of HSOS ,CT dynamic enhanced is a powerful supplement to Baltimore standard ,which is worth attention .

关 键 词：CT动态增强扫描 巴尔的摩标准 肝窦阻塞综合征 诊断 

分 类 号：R575[医药卫生—消化系统] R816.5[医药卫生—内科学]