连续CT检查对病毒性慢性肝病的诊断价值

Serial CT examinations for diagnosis of chronic viral liver disease

目的:评价连续CT检查对病毒性慢性肝病的临床应用价值。方法:回顾性分析42例病毒性慢肝患者连续螺旋CT检查>2年的系列图像,测量肝(左、右叶)及脾体积,以及侧支循环的范围及程度。所有病例的CT表现与肝功能(按Child-Phgh分级)和肝组织学结果进行对照。结果:13例Child分级积分增加(积分增加组),其余积分无改变(积分不变组)。在积分增加组初次检查与末次检查相比肝体积比率明显变小(P<0.05),右叶体积比率也明显变小(P<0.01)。左叶及脾体积比率在初末次检查均无明显变化(P>0.05)。积分不变组中有6例初末次检查示侧支循环的范围及程度均有发展。结论:连续CT检查对评价病毒性慢性肝病十分有用。肝体积变小,尤其是右叶体积变小提示病情进展。

Objective： To evaluate the usefulness of serial CT examinations in the diagnosis of chronic viral liver disease. Methods： We calculated the liver （left and right lobes） and spleen volums of 42 patients with chronic viral liver disease,who were examined serially for〉 2 years by using helical CT scanner. The level and scope of collateral formations were also checked. These CT findings were compared with the liver function tests by Child-Pugh score and histologic examination. Results： The Child-Pugh score got worse in 13 patients（score-increased group）and did not change in the other patients（score-static group）.The liver volume ratio berween the first and last CT examinations was significantly smaller in the score-increased group than in the score-static group（ P 〈 0.05） .The right lobe volume ratio was also significantly smaller in the score-increased group（ P 〈 0.01 ）. The left lobe volume ratio and spleen volume ratio were not significantly different between the two groups （ P 〉 0.05）. In six patients collateral formations progressed. Conclusion： Serial CT examinations are useful to evaluate patients with chronic viral liver disease. When liver volume, especially for right lobe volume get smaller, it means progression of the disease.