多层螺旋CT门静脉成像评估肝硬化食管静脉曲张出血风险

Evaluation of esophageal varice bleeding risk in cirrhosis by multi-slice spiral CT portography

目的本文旨在评估多层螺旋CT(MSCT)门静脉重建对肝硬化门脉高压患者食管静脉曲张破裂出血风险的预测价值。方法选取94例肝硬化可疑食管静脉曲张患者,1周内行MSCT和上消化道内镜检查。内镜排除合并胃底静脉曲张患者,共80例单纯食管静脉曲张患者入选本实验,对比分析MSCT及内镜资料。结果食管曲张静脉评分、曲张静脉最大直径以及栅栏状静脉扩张均与内镜下曲张静脉形态、有无红色征及其严重程度明显相关。MSCT门静脉成像在判断红色征方面(≥4 mm)的灵敏度、特异度分别为71.3%、89.1%。结论 MSCT门静脉成像与内镜对食管静脉曲张程度的显示具有很好的一致性,可以作为预测曲张静脉出血的有效指标。

Objective To evaluate the ability of multi-slice spiral CT （MSCT） portography to predict a risk of e- sophageal varice hemorrhage in patients with liver cirrhosis and portal hypertension. Methods A total of 94 patients with cirrhosis were enrolled in this study. All patients were examined by endoscopy and 64-slice spiral CT scan within one week. Finally, a total of 80 cases only with esophageal varice were selected. The results of MSCT portography were compared with endoscopy. Results The variceal score, the maximum short axis of the varices, and the presence of pali- sade vein dilatation obtained from MSCT had signicant correlation with endoscopic variceal forms, and the presence and severity of RC sign, respectively. The sensitivity and specificity in evaluating mediate and severe （ ≥4 ram） esophageal varices with MSCT portography were 71.3% and 89.1% , respectively. Conclusion MSCT portography had high consis- tency with endoscopy in showing esophageal varices. MSCT is useful in the evaluation of esophageal varices for predic- ting a risk of hemorrhage.