CT与核磁共振诊断脂肪肝准确性及CT检查与辨证分型的关系研究  

Study on the Accuracy of CT and MRI in Diagnosis of Fatty Liver and the Relationship between CT Examination and Syndrome Differentiation of Traditional Chinese Medicine

作　　者：胡天翔[1] HU Tianxiang(Radiology Department, the Fourth Affiliated Hospital of China Medical University, Liaoning Province, Shenyang 110032, China)

机构地区：[1]中国医科大学附属第四医院放射线科

出　　处：《中国中医药现代远程教育》2019年第11期53-55,共3页Chinese Medicine Modern Distance Education of China

摘　　要：目的分析研究CT与核磁共振诊断脂肪肝的准确性以及CT检查与中医辨证分型的关系。方法此次将我院于2017年1月—2018年1月收治的脂肪肝患者128例作为研究的对象,均实施CT与核磁共振(MRI)方法进行诊断,然后对两种诊断方法的准确性;进一步通过中医辨证分型分析,判断CT检查和中医辨证分型之间的关系。结果在诊断准确率方面,CT诊断为97.66%,与MRI诊断为70.31%,CT诊断的准确率显著要比MRI诊断高,2组数据之间存在明显差异性(P<0.05)。根据中医辨证分型,其中肝郁脾虚证17例,肝/脾CT值比值为(0.895±0.236);湿热内蕴证54例,肝/脾CT值比值为(0.895±0.236);痰淤互结证28例,肝/脾CT值比值为(0.622±0.149);痰湿内阻证23例,肝/脾CT值比值为(0.774±0.190);肝肾不足证5例,肝/脾CT值比值为(0.594±0.137)。由数据可知,肝郁脾虚证的肝/脾CT值比值最高,肝肾不足证的肝/脾CT值则最低,两组数据存在明显统计学差异(P<0.05)。根据脂肪肝中医辨证分型和脂肪肝病变程度之间的关系结果分析显示:对于肝郁脾虚证患者,占比最高的是轻度脂肪肝;而对于湿热内蕴证、痰淤互结证、痰湿内阻证患者,则占比最高的是中度脂肪肝;此外,肝肾不足证患者占比最高的是重度脂肪肝。结论在临床中针对脂肪肝疾病患者,采取CT诊断的效果优于MRI诊断,因此可择优选择CT诊断方法;同时,CT检查与中医辨证分型之间存在较为密切的关系;因此,临床可采取CT诊断脂肪肝的同时,联合中医辨证分型分析,以此为进一步的临床诊疗工作提供客观、科学的参考依据。Objective To analyze the accuracy of CT and magnetic resonance in the diagnosis of fatty liver and the relationship between CT examination and TCM syndrome differentiation and typing. Methods 128 cases of fatty liver patients admitted to our hospital from January 2017 to January 2018 were selected as the research objects. All patients were diagnosed by CT and magnetic resonance imaging (MRI), and then the accuracy of the two diagnostic methods was evaluated. The relationship between CT examination and TCM syndrome differentiation was further judged by TCM syndrome differentiation analysis. Results The diagnostic accuracy of CT was 97.66%, and the diagnostic accuracy of MRI was 70.31%. The diagnostic accuracy of CT was significantly higher than that of MRI, and there was a significant difference between the two groups (P<0.05). According to TCM syndrome differentiation, there were 17 cases of liver depression and spleen deficiency syndrome, the ratio of liver/spleen CT value was (0.895±0.236);54 cases of damp-heat syndrome, the ratio of liver/spleen CT value was (0.895±0.236), 28 cases of phlegm stagnation syndrome, the ratio of liver/spleen CT value was (0.622±0.149), 23 cases of phlegm-dampness syndrome, the ratio of liver/spleen CT value was (0.774±0.190), 5 cases of liver-kidney insufficiency syndrome. The ratio of liver/spleen CT value was (0.594±0.137). According to the data, the ratio of liver/spleen CT value of liver depression and spleen deficiency syndrome is the highest, while that of liver/spleen CT value of liver and kidney deficiency syndrome is the lowest. There is significant statistical difference between the two groups (P<0.05). According to the analysis of the relationship between TCM syndrome differentiation of fatty liver and the degree of fatty liver pathological changes, it shows that the highest proportion of patients with liver depression and spleen deficiency syndrome is mild fatty liver, while the highest proportion of patients with dampness-heat syndrome, phlegm-stasis syndrome and

关 键 词：CT诊断 核磁共振诊断(MRI) 脂肪肝 辨证分型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R816.5[医药卫生—诊断学] R575.5[医药卫生—临床医学]