慢性乙肝患者肝脏CT检查与肝穿病理改变的对照研究

Control study between CT examination and liver biopsy pathology in patients with chronic hepatitis B.

目的了解肝脏CT检查对早期肝硬化的诊断价值及其与肝纤维化程度的相关性。方法152例慢性乙型病毒性肝炎患者经皮肝脏穿刺活检术行病理组织学检查,同时行肝脏CT检查,测量肝脾CT值、门静脉及脾静脉宽度及脾脏大小。结果152例患者中肝活检显示37例为早期肝硬化,CT检查33例为早期肝硬化,提示CT对早期肝硬化诊断的诊断灵敏度81.08%,特异度90.91%,误诊率9.09%,漏诊率18.91%。结论肝脏CT检查对早期肝硬化的诊断灵敏度较高,可以作为慢性乙型肝炎患者的常规检查项目,从而有助于早期肝硬化的诊断,并指导积极抗病毒治疗。

Objective To discuss the diagnostic value of computerized tomography （CT） examination in patients with early liver cirrhosis and the relationship of different stages of liver fibrosis. Methods 152 patients with chronic hepatitis B were undertaken liver biopsy and CT examination for liver and spleen＇s CT values, width of main portal vein （MPV）, splenic vein （SPV） were calculated. Results 37 of 152 patients were diagnosed as early liver cirrhosis. The diagnostic sensitivity, specificity, misdiagnosis rate, missed diagnostic rate of CT examination for early liver cirrhosis were 81.08%, 90. 91%, 9.09% and 18.91% respectively. Conclusion CT was more sensitive examination in diagnosing early liver cirrhosis. It should be a routine examination in patients with active chronic hepatitis B and it may conduce to diagnosis early liver cirrhosis and guide antivirus therapy.