CT肝-膈肌间脂肪疝入征及右膈肌增厚征诊断早期肝硬化  

Hepato-diaphragmatic fat interposition and right diaphragmatic thickening signs on CT for diagnosing early cirrhosis

作　　者：李燕花 艾竹 向之明 贺雪平 LI Yanhua;AI Zhu;XIANG Zhiming;HE Xueping(Department of Radiology,Guangzhou Panyu Central Hospital,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中心医院放射科,广东广州511400

出　　处：《中国介入影像与治疗学》2022年第12期774-777,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：广州市番禺区科技计划项目(2021-Z04-094)。

摘　　要：目的观察CT所见肝-膈肌间脂肪疝入征及右膈肌增厚征用于诊断早期肝硬化的价值。方法对47例临床诊断早期肝硬化患者(肝硬化组)及45名健康体检者(对照组)行上腹部CT,于门静脉期薄层CT图像显示右侧肾上腺层面测量肝-膈肌间脂肪面积、肝-膈肌脂肪横径(F)、肝右叶横径(D)及双侧膈肌厚度,以F/D值≥0.5为肝-膈肌间脂肪疝入征阳性,以右膈肌与左膈肌厚度之差>2 mm为右侧膈肌增厚征阳性。比较组间相关CT参数差异,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估CT所见肝-膈肌间脂肪面积、肝-膈肌间脂肪疝入征阳性及右侧膈肌增厚征阳性诊断早期肝硬化的效能。结果组间肝-膈肌间脂肪面积、F/D值、肝-膈肌间脂肪疝入征阳性率、双侧膈肌厚度之差及右膈肌增厚征阳性率差异均有统计学意义(P均<0.01)。根据肝-膈肌间脂肪面积、肝-膈肌间脂肪疝入征阳性及右膈肌增厚征阳性诊断早期肝硬化的AUC分别为0.67、0.78及0.79,敏感度分别为57.40%、85.10%及72.30%,特异度分别为80.00%、66.70%及82.20%。结论CT所见肝-膈肌间脂肪疝入征及右膈肌增厚征有助于诊断早期肝硬化。Objective To observe the value of hepato-diaphragmatic fat interposition and right diaphragmatic thickening signs on CT for diagnosing early cirrhosis.Methods Upper abdominal CT scanning were performed on 47 patients with clinically diagnosed early cirrhosis(cirrhosis group)and 45 healthy subjects(control group).The hepato-diaphragmatic interstitial fat area,hepatic-diaphragmatic fat transverse diameter(F),hepatic right lobe transverse diameter(D)and bilateral diaphragm thickness were measured at the right adrenal display level in portal phase thin-layer CT images.F/D value≥0.5 was considered as positive of hepato-diaphragmatic fat interposition,while the difference of bilateral diaphragm thickness>2 mm was considered as positive of right diaphragmatic thickening.CT-related parameters were compared between groups.Receiver operating characteristic(ROC)curves were drawn,and the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of hepato-diaphragmatic fat area,hepato-diaphragmatic fat interposition sign positive and right diaphragmatic thickening sign positive for diagnosing early cirrhosis.Results There were significant differences of the hepato-diaphragmatic interstitial fat area,F/D value,the rate of hepato-diaphragmatic fat interposition positive sign,the difference of bilateral diaphragm thickness and the rate of right diaphragmatic thickening sign between groups(all P<0.01).The AUC of hepato-diaphragmatic fat area,hepato-diaphragmatic fat interposition positive sign and right diaphragm thickening sign in diagnosis of early cirrhosis was 0.67,0.78 and 0.79,respectively.The sensitivity was 57.40%,85.10%and 72.30%,and the specificity was 80.00%,66.70%and 82.20%,respectively.Conclusion Hepato-diaphragmatic fat interposition sign and right diaphragmatic thickening sign on CT was helpful for diagnosis of early cirrhosis.

关 键 词：肝硬化 体层摄影术 X线计算机 肝-膈肌间脂肪疝入征 右侧膈肌增厚征 

分 类 号：R657.3[医药卫生—外科学] R814.42[医药卫生—临床医学]