多层螺旋CT及MRI在肝小静脉闭塞症检查中的应用效果  

The application of multi slice spiral CT and MRI in the examination of hepatic veno occlusive disease

作　　者：欧阳红 胡永梅 OUYANG Hong;HU Yongmei(Image Center,Xinyu People's Hospital,Xinyu,Jiangxi,338000,China)

机构地区：[1]新余市人民医院影像中心,江西新余338000

出　　处：《当代医学》2023年第23期19-23,共5页Contemporary Medicine

摘　　要：目的分析多层螺旋CT(MSCT)单独及联合MRI诊断肝小静脉闭塞症(HVOD)的应用效果。方法选取2020年1月至2021年1月于新余市人民医院接受检查的60例疑似HVOD患者作为研究对象,所有患者均先行MSCT单独检查,后行MRI检查,以肝穿刺病理检查为金标准,比较MSCT单独及联合MRI检查的检查结果、影像学表现及诊断价值。结果肝穿刺病理结果显示,60例疑似HVOD患者中,49例确诊为HVOD,确诊率为81.67%;MSCT结果显示,37例确诊为HVOD,MSCT联合MRI检查结果显示,46例确诊为HVOD。MSCT检查显示,肝脏整体肿大、饱满,伴有不同程度的肝腹水,部分患者存在肝实质弥漫性降低;MRI检查显示,T1WI信号减低,T2WI信号增高,多数患者下腔静脉肝段受压变扁,但肝静脉血流充盈良好,无栓塞现象。MSCT单独检查与联合检查的食管静脉扩张、肝脏门静脉周围肿胀、小肠管壁变厚、胆囊壁肿胀及变厚检出率比较差异无统计学意义。联合检查检出率、灵敏度、准确度均高于MSCT单独检查(P<0.05),但MSCT单独检查与联合检查特异度比较差异无统计学意义。结论与单纯MSCT检查比较,联合MRI能更清晰地了解患者肝脏整体及血管解剖形态,两者联合可提高HVOD诊断的价值。Objective To analyze the effects of multi slice spiral CT(MSCT)alone and combined with MRI in the diagnosis of hepatic veno occlusive disease(HVOD).Methods 60 suspected HVOD patients who underwent examination at Xinyu People's Hospital from January 2020 to January 2021 were selected as the research subjects,all patients underwent MSCT alone examination before MRI examination.The examination results,imaging manifestations,and diagnostic value were compared between MSCT alone and combined with MRI examination.Results The pathological results of liver puncture showed that 49 cases were diagnosed with HVOD among 60 cases of suspected HVOD patients,with diagnosis rate of 81.67%;the results of MSCT showed that 37 cases were diagnosed with HVOD,and the results of MSCT combined with MRI showed that 46 cases were diagnosed with HVOD.MSCT examination showed that the liver was generally enlarged and plump,accompanied by varying degrees of liver ascites,and some patients had diffuse reduction of liver parenchyma;MRI examination showed a decrease in T1WI signal and an increase in T2WI signal,most patients had compressed and flattened hepatic segments of the inferior vena cava,but the hepatic venous blood flow was well filled without embolism.There were no statistically significant differences in the detection rates of esophageal vein dilation,swelling around the liver portal vein,thickening of the small intestine wall,and swelling and thickening of the gallbladder wall between MSCT alone and combined examinations.The examination rate,sensitivity,and accuracy of combined examination were higher than MSCT alone examination(P<0.05),but there was no statistically significant difference in the specificity between MSCT alone examination and combined examination.Conclusion Compared with simple MSCT examination,combined MRI can provide a clearer understanding of the overall liver and vascular anatomy of patients,and the combination of the two can improve the diagnostic value of HVOD.

关 键 词：肝小静脉闭塞症 多层螺旋CT MRI 诊断 

分 类 号：R575[医药卫生—消化系统] R730.44[医药卫生—内科学]