多层螺旋CT动态增强门腔间隙宽度与改良肝尾/右叶比值的关系  

Relationship Between the Width of Portacaval Space and the Improvement of Hepatic Caudate/Right Lobe Ratio in Dynamic Enhanced Multi-slice Spiral CT

作　　者：张文煜 曹和涛[2] 刘婷婷[2] 李宁[2] 于芹[2] 

机构地区：[1]扬州市第二人民医院影像科,江苏扬州225007 [2]南通大学附属医院影像科,江苏南通226001

出　　处：《中国医学影像学杂志》2016年第5期353-356,共4页Chinese Journal of Medical Imaging

摘　　要：目的分析多层螺旋CT动态增强门腔间隙（PCS）宽度与改良肝尾/右叶比值（C/RL-r）的关系,探讨PCS增宽诊断肝硬化的价值。资料与方法回顾性分析215例住院患者的临床CT资料,测量PCS宽度及门腔间隙淋巴结（PCN）前后径,分析PCS宽度与C/RL-r的相关性,比较C/RL-r≥0.9及C/RL-r〈0.9患者的PCS宽度及PCN前后径。结果 C/RL-r≥0.9组70例,C/RL-r〈0.9组145例,临床诊断肝硬化分别为43例和29例（χ^236.378,P〈0.01）。两组PCS上、下两段宽度及PCN短径比较,差异均有统计学意义（P〈0.05）;两组PCS下段肝组织出现率分别为55.71%和15.17%,差异有统计学意义（χ^238.182,P〈0.01）。C/RL-r≥0.9组PCS上、下两段宽度与C/RL-r呈显著正相关（r=0.826、0.815,P〈0.01）。以影像综合诊断结果为标准,PCS上、下两段宽度诊断肝硬化的准确度分别为77.0%和75.0%。结论 C/RL-r≥0.9患者PCS宽度与C/RL-r呈显著正相关,尾叶和PCN增大推移及肝萎缩牵拉是PCN增宽的主要原因,对诊断肝硬化有一定的价值。Purpose To analyze the relationship between the width of portacaval space（PCS） and modified caudate-right lobe with use of the right portal vein to set the lateral boundary（C/RL-r） by dynamic enhanced MSCT, and explore the value of PCS broadening in the diagnosis of liver cirrhosis. Materials and Methods The clinical CT data of 215 hospitalized patients was retrospectively analyzed, the width of PCS and anteroposterior diameter of portacaval node（PCN） were measured, the correlation between the former and C/RL-r was analyzed, and the width of PCS and anteroposterior diameter of PCN was compared between the group with C/RL-r ≥ 0.9 and the other group with C/RL-r0.9. Results Seventy cases with C/RL-r ≥ 0.9, among them 43 cases were clinically diagnosed as liver cirrhosis, 145 cases with C/RL-r0.9, with 29 cases of clinically diagnosed liver cirrhosis（χ^236.378, P〈0.01）. There were statistically significant differences between the two groups when comparing the upper and lower width of PCS and short axis of PCN（P〈0.05）. The rate of possession of liver tissue in lower PCS was 55.71% and 15.17%, respectively, with statistically significant difference（χ^238.182, P〈0.01）. There was obvious positive relationship between the width of the upper and lower PCS and C/RL-r in C/RL-r ≥ 0.9 group（r=0.826 and 0.815, P〈0.01）. Using comprehensive imaging results as reference standard, the diagnostic accuracy of the width of the upper and lower PCS for liver cirrhosis was 77.0% and 75.0%, respectively. Conclusion There are highly positive correlation between the width of PCS and C/RL-r in group with C/RL-r ≥ 0.9, the displacement of enlarged caudate lobe and PCN and pull of liver atrophy may be the main reason of PCS broadening, which have a certain value to the diagnosis of liver cirrhosis.

关 键 词：肝硬化 体层摄影术 螺旋计算机 图像增强 门腔间隙 

分 类 号：R657.31[医药卫生—外科学] R445.3[医药卫生—临床医学]