基于能谱CT成像的脾脏血流参数在CPH患者GOV程度中的评估价值  

Splenic Blood Flow Parameters Based on Energy Spectrum CT Imaging Were Used to Evaluate the Degree of Esophageal and Gastric Varices in Cirrhotic Patients with Portal Hypertension

作　　者：果鑫园 崔婷 GUO Xin-yuan;CUI Ting(Department of Radiology,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院放射科,北京100038

出　　处：《中国CT和MRI杂志》2024年第4期106-108,共3页Chinese Journal of CT and MRI

基　　金：中国国家铁路集团有限公司科技研究开发计划项目(J2022Z616)。

摘　　要：目的探讨基于能谱CT成像的脾脏血流参数在肝硬化门静脉高压症(CPH)患者食管胃底静脉曲张(GOV)程度中的评估价值。方法回顾性分析80例CPH患者临床资料(研究组),另将同期肝脏CT正常的38例患者纳入对照组,记录基于能谱CT成像行腹部增强CT扫描的各参数,以胃镜检查结果胃金标准,分析基于能谱CT成像的脾脏血流参数在评估CPH患者GOV程度中的价值。结果胃镜检查发现,0级16例,1级19例、2级33例、3级12例;对照组脾静脉直径(D-SV)、脾脏实际门静脉期碘浓度(IC-S)、脾脏体积(V-S)、脾脏碘容量(IV-S)均较研究组更低(P<0.05),随着疾病分级的递增,研究组V-S、IC-S、IV-S、D-SV呈升高趋势(P<0.05);以0级患者作为对照,经分析得出脾脏血流各参数联合在CPH患者GOV中诊断AUC值为0.879,敏感度为71.25%、特异度为89.37%;脾脏血流各参数联合在CPH患者GOV重度中诊断AUC值为0.825,敏感度为70.33%、特异度为83.69%。结论应用能谱CT检测,可结合功能学及形态学角度,分析不同程度GOV患者脾脏血流动力学改变情况,对GOV早期诊断及曲张严重程度的评估提供客观依据,值得推广。Objective To investigate the value of splenic blood flow parameters based on energy spectrum CT imaging in evaluating the degree of esophagogastric varices(GOV)in cirrhotic patients with portal hypertension(CPH).Methods Clinical data of 80 patients with CPH(study group)were retrospectively analyzed,and 38 patients with normal liver CT during the same period were included in the control group.Parameters of abdominal enhanced CT scan based on energy spectrum CT imaging were recorded,and the value of spleen blood flow parameters based on energy spectrum CT imaging in evaluating GOV degree of CPH patients was analyzed according to the gold standard of gastroscopy results.Results Gastroscopy showed that 16 cases were grade 0,19 cases were grade 1,33 cases were grade 2,and 12 cases were grade 3.The splenic vein diameter(D-SV),actual portal vein iodine concentration(IC-S),spleen volume(V-S)and spleen iodine volume(IV-S)in control group were lower than those in study group(P<0.05).With the increase of disease grade,V-S,IC-S,IV-S and D-SV in study group showed an increasing trend(P<0.05).Taking grade 0 patients as control,the diagnostic AUC value of spleen blood flow combined with each parameter in GOV of CPH patients was 0.879,sensitivity was 71.25%,and specificity was 89.37%.The combined value of splenic blood flow parameters in the diagnosis of severe esophagogastric fundus varices in cirrhotic portal hypertension patients was 0.825,the sensitivity was 70.33%,and the specificity was 83.69%.Conclusion The application of energy spectrum CT detection can be combined with functional and morphological perspectives to analyze the changes of spleen hemodynamics in patients with different degrees of GOV,providing an objective basis for the early diagnosis of GOV and the evaluation of the severity of varices,which is worthy of promotion.

关 键 词：能谱CT成像 脾脏血流参数 肝硬化 门静脉高压症 食管胃底静脉 曲张程度 

分 类 号：R575.2[医药卫生—消化系统] R445[医药卫生—内科学]