超声与CT诊断肝小静脉闭塞病的对比研究

The contrast of ultrasond and CT in diagnosis of hepatic veno-occlusive disease

目的:探讨肝小静脉闭塞病(HVOD)的超声和CT影像特点,比较两者的诊断价值。方法:32例HVOD由肝穿刺活检病理证实(12例)和临床诊断(20例)。急性期16例,亚急性期10例,慢性期6例。所有病例均行超声和CT检查,比较两者诊断价值。结果:急性期16例超声和CT均表现典型,诊断一致;亚急性期10例中超声诊断正确8例,CT诊断正确6例,其中2例超声漏诊,而CT诊断正确;慢性期6例中超声诊断正确4例,CT全部漏诊。总体比较,超声诊断HVOD符合率为87.50%(28/32),CT诊断符合率为68.75%(22/32例),差异无统计学意义(χ2=3.2,P>0.05)。结论:HVOD急性期两者诊断价值一致,亚急性和慢性患者超声影像优于CT扫描。超声为首选影像检查,CT可作必要的补充。

Objective：To evaluate the features of both ultrasonography and CT in the diagnosis of hepatic veno-occlusive disease （HVOD）. Methods：32 cases of HVOD were confirmed by liver biopsy （12 cases） and clinical diagnosis （20 cases）,including acute （16）,subacute （10）,and chronic cases （6）. All patients underwent both ultrasonic and CT examinations in order to compare their diagnostic value. Results：In acute phase,all 16 cases were correctly diagnosed by ultrasonography or CT due to typical manifestations; in subacute phase,8/10 and 6/10 cases were correctly diagnosed by ultrasonography and CT,respectively; in chronic phase,4/6 cases were correctly diagnosed by ultrasonography,but all missed by CT. The diagnostic coincidence rates of HVOD were 87.50% （28/32） and 68.75% （22/32） for ultrasonography and CT with no significant difference between them （χ2=3.2,P0.05）. Conclusion：In acute phase,CT and ultrasonography share the same diagnostic value in the diagnosis of HVOD,but the latter is superior in diagnosing subacute and chronic HVOD. Ultrasonography may be the first choice for diagnosing HVOD,while,CT is a supplement.