肝炎肝硬化患者肝脏MRI分数评定及其临床意义

Analysis on the correlation between liver MRI scores and clinical severity in viral hepatitis-induced cirrhosis

目的探讨肝炎肝硬化患者肝脏MRI分数与Child-Pugh分级之间的关系。方法48例肝炎肝硬化病人均进行肝脏MRI平扫检查,观察测量肝脏长径、腹水厚度、侧枝循环数目等参数,并与Child-Pugh分级进行相关性分析。结果Child-Pugh分级与侧枝循环数目、腹水厚度呈显著正相关(P<0.01),与肝脏长径呈显著负相关(P<0.05)。肝脏MRI分数与Child-Pugh分级呈显著正相关(r=0.935,P<0.01);运用肝脏MRI评分系统区分Child-Pugh A级与其他级别的肝硬化,其准确度、敏感性、特异性分别为93.8%、95.2%及92.6%。结论基于侧枝循环数目、腹水厚度及肝脏长径三项指标的肝脏MRI评分系统,可良好地运用于评估肝硬化的临床严重程度。

Objective To analyze the relationship between liver MRI scores and Child-Pugh grades.Methods Liver MRI plain scans were performed in 48 patients with rival hepatitis-induced cirrhosis.Parameters of the length of liver,the thickness of ascites and the presence of collaterals were measured.The correlation were assessed between these parameters and Child-Pugh grades.Results The thickness of ascites and the number of collaterals were significantly and positively correlated with Child-Pugh grades（P0.01）.The length of liver was significantly and negatively correlated with Child-Pugh grades（P0.05）;Significant and positive correlation was found between liver MRI scores and Child-Pugh grades（r=0.935,P0.01）;The accuracy of MRI scoring system in distinguishing between Child-Pugh grade A and grades B/C was 93.8%,with the sensitivity 95.2%,and the specificity 92.6%.Conclusion The clinical severity of liver cirrhosis can be well evaluated by using a liver MRI scoring system based on the presence of collaterals,the thickness of ascites and the liver length.