能谱CT成像参数与肝硬化病情程度和肝功能的相关性及对EGVB的预测价值  

The Correlation between the Imaging Parameters of Spectral CT and the Severity of Liver Cirrhosis,Liver Function,and the Predictive Value of EGVB

作　　者：彭金平 孙淑钦 田成斌 PENG Jinping;SUN Shuqin;TIAN Chengbin(Pingmei Shenma Medical Group General Hospital Radiology Department Pingdingshan)

机构地区：[1]平煤神马医疗集团总医院放射科,河南平顶山467000

出　　处：《长治医学院学报》2024年第4期293-297,共5页Journal of Changzhi Medical College

基　　金：河南省医学科技攻关联合共建项目(LHGJ20193103)。

摘　　要：目的:探讨能谱CT成像参数与肝硬化病情严重程度、肝功能的相关性及对食管胃底静脉曲张出血(EGVB)的预测价值。方法:选取124例肝硬化门脉高压患者作为研究对象,入院后均行能谱CT检查,比较不同Child-Pugh分级肝硬化患者能谱CT成像参数[肝碘浓度比率(LIC)、肝脾动脉期碘浓度比率(LSA)、脾碘浓度比率(SIC)、肝脾静脉期碘浓度比率(LSV)]、肝功能指标[谷草转氨酶(AST)、胆碱酯酶(CHE)、白蛋白(ALB)、谷丙转氨酶(ALT)],分析能谱CT成像参数与Child-Pugh分级、肝功能指标相关性,随访6个月,将患者分为发生EGVB组和未发生EGVB组,比较2组患者能谱CT成像参数,并分析其对EGVB的预测价值。结果:不同Child-Pugh分级肝硬化患者能谱CT成像参数LIC、SIC、LSV比较,A级>B级>C级,不同Child-Pugh分级肝硬化患者肝功能指标AST、ALT比较,A级<B级<C级,ALB、CHE比较,A级>B级>C级,差异均有统计学意义(P<0.05);经相关性分析发现,Child-Pugh分级、AST、ALT与LIC、SIC、LSV呈负相关,与LSA呈正相关,ALB、CHE与LIC、SIC、LSV呈正相关,与LSA呈负相关(P<0.05);发生EGVB患者入院时LIC、SIC、LSV低于未发生EGVB患者,LSA高于未发生患者(P<0.05);能谱CT成像参数LIC、SIC、LSA、LSV对肝硬化门脉高压患者发生EGVB联合预测AUC为0.939,大于单一参数(P<0.05)。结论:能谱CT成像参数可用于评估肝硬化病情程度、肝功能,为临床早期预测EGVB发生风险提供参考。Objective:To investigate the correlation between spectral CT imaging parameters and the severity of liver cirrhosis and liver function,as well as the predictive value of spectral CT imaging parameters for esophageal and gastric variceal bleeding(EGVB).Methods:A total of 124 patients with cirrhosis and portal hypertension were selected as the research subjects.All patients underwent spectral CT examination after admission,and the spectral CT imaging parameters [liver iodine concentration ratio(LIC),liver and spleen artery phase iodine concentration ratio(LSA),spleen iodine concentration ratio(SIC),liver and spleen vein phase iodine concentration ratio(LSV)] and liver function indicators [aspartate aminotransferase(AST),cholinesterase(CHE),albumin(ALB),alanine aminotransferase(ALT)] were compared among patients with different Child-Pugh classifications of cirrhosis.The correlation between spectral CT imaging parameters and Child-Pugh classification and liver function indicators was analyzed.After a follow-up period of 6 months,the patients were divided into the EGVB group and non-EGVB group,and the spectral CT imaging parameters of the two groups were compared,and their predictive value for EGVB was analyzed.Results:The comparison of spectral CT imaging parameters LIC,SIC,and LSV in patients with different Child-Pugh classifications of cirrhosis:A>B>C;the comparison of liver function indicators AST and ALT in patients with different Child-Pugh classifications of cirrhosis:A<B<C,ALB and CHE:A>B>C,with significant differences(P<0.05);correlation analysis found that Child-Pugh classification,AST,ALT were negatively correlated with LIC,SIC,and LSV,and positively correlated with LSA,while ALB and CHE were positively correlated with LIC,SIC,and LSV,and negatively correlated with LSA(P<0.05);patients with EGVB had lower LIC,SIC,and LSV at admission than those without EGVB,and higher LSA than those without EGVB(P<0.05);the AUC of spectral CT imaging parameters LIC,SIC,LSA,and LSV for predicting the co-occurrence of EGVB in

关 键 词：能谱CT成像 肝硬化 肝功能 食管胃底静脉曲张出血 

分 类 号：R816.5[医药卫生—放射医学]