摘要
目的:通过能谱CT探讨肝硬化门脉高压血流动力学改变来预测食管静脉曲张出血风险。方法:41名肝硬化患者行能谱CT扫描,分别记录肝左叶、肝右叶、肝尾状叶、脾脏、门静脉、胃左静脉碘基值,门静脉主干及脾静脉主干内径,比较门脉高压组(门静脉内径≥15mm或脾静脉内径≥10mm)与非门脉高压组(门静脉内径<15mm或脾静脉内径<10mm)、CT下食管静脉曲张组与未曲张组、出血组与未出血组之间能谱参数差异。将出血组与未出血组的能谱参数绘制ROC曲线,选取截点,确定能谱参数对出血风险的诊断价值。结果:胃左静脉指数GLI(胃左静脉碘基值/门静脉碘基值)与脾静脉主干内径呈正相关(r=0.358,P=0.035)。CT下食管静脉曲张组GLI(0.99±0.26)较未曲张组高(0.78±0.22),P=0.02。出血组GLI(1.01±0.21)较未出血组高(0.83±0.28),P=0.037。GLI临界值为0.87时曲线下面积为0.71,诊断出血风险的敏感性82.4%,特异性65%。结论:胃左静脉指数可以作为预测食管静脉曲张出血风险指标。
Objective：The purpose of this report was to investigate the haemodynamics of portal hypertension of hepatic cirrhosis by use of spectral CT to evaluate the risk of variceal bleeding.Methods：Forty-one patients with hepatic cirrhosis were selected into our study underwent three-phase spectral CT scans and analyzed retrospectively.The iodine concentrations for hepatic and splenic parenchyma on arterial and portal vein phases were measured using the iodine-based material decomposition images.The left gastric vein index（GLI）was obtained by dividing the iodine concentration of the left gastric vein from that of the portal vein.The diameters of main portal vein and spleen vein were also measured.The comparisons of spectral parameters between hypertension and non-hypertension group,variceal and non-variceal group,bleeding and non-bleeding group were analyzed and ROC curves were drawn based on recorded data.Results：The GLI was positively correlated with the spleen vein diameter and the correlation coefficient was 0.358（P=0.035）.The GLI was（0.99±0.26）in the variceal group and（0.78±0.22）in the non-variceal group with significant difference（P〈0.05）.The GLI was（1.01±0.21）in the bleeding group and（0.83±0.28）in the non-bleeding group with significant difference（P〈0.05）.The cut-off value of GLI was 0.87.The area under ROC curve was 0.71.The sensitivity and specificity for predicting EVB was82.4% and 65%,respectively.Conclusion：The GLI can be useful to predict the risk of esophageal variceal haemorrhage.
出处
《放射学实践》
北大核心
2015年第7期763-767,共5页
Radiologic Practice
