CT平扫定量评定门脉高压及其对周围器官的影响

Quantitative assessment of portal hypertension and its effect on the peripheral organs by CT plain scanning

目的探讨CT平扫定量在评定门脉高压及其对周围实质器官影响中的价值。方法回顾分析86例患者的CT平扫资料,其中45例为门脉高压患者,设为门脉高压组,41例为正常人群,设为正常组,观测2组的门脉左右肢汇合部、门脉汇合部同一扫描层腹主动脉、胰腺、双肾及脾脏的CT值,门脉高压组按肝功能分级对以上各部位所对应的CT值计数并进行统计分析。结果门脉高压组门脉左右支汇合部、同一扫描层腹主动脉、胰腺、双肾及脾脏的CT值分别为(36.97±5.81)、(41.06±7.22)、(42.64±6.07)、(33.18±4.20)及(45.29±4.60)HU;正常组相应部位CT值分别为(43.92±5.71)、(47.19±5.80)、(50.06±7.80)、(36.12±4.50)及(52.38±4.95)HU;以上部位肝功能A、B及C级对应CT值分别为(39.57±4.56)、(36.56±5.46)、(31.24±5.23);(45.23±6.73)、(40.86±6.92)、(36.06±7.12);(45.97±6.07)、(42.76±6.35)、(38.67±7.35);(37.33±4.09)、(33.46±3.97)、(28.23±4.13);(48.66±4.38)、(45.03±4.43)、(40.12±5.32)HU;方差分析显示,门脉高压组与正常组的门脉、腹主动脉、胰腺、双肾及脾脏的CT值差异有统计学意义(P<0.05),肝功能A、B和C级各部位组内差异有统计学意义(P<0.05)。结论门脉高压时,门脉、腹主动脉、胰腺、双肾及脾脏的CT值将降低,而且肝功能分级越高,CT值越低,提示门脉高压时,对周围器官的功能及主动脉血流动力学有一定的影响。

Objective To investigate the value of CT plain scanning in the quantitative assessment of portal hypertension and its effect on the peripheral organs. Methods A respective analysis was made on the CT scan data of 86 people, of whom 45 were pa-tients with portal hypertension （the portal hypertension group） and 41 were normal adults （the control group）. Close observation was made on the CT values of the portal right and left branch junction, the abdominal aorta in the same scanning layer, the pancreas, the double kidneys and the spleen of the 2 groups. The patients in the portal hypertension group were classified in accordance with liver function, then, measurements and statistical analyses were made in the CT values of the above corresponding parts. Results The CT values of the portal right and left branch junction, the abdominal aorta in the same scanning layer, the pancreas, the double kidneys and the spleen were respectively （36.97 ±5. 81）, （41. 06 ± 7. 22） , （42. 64 ±6. 07） , （33.18 ±4.20） and （45. 29 ± 4. 60） HU, while those of the control group were respectively （43. 92 ±5. 71 ）,（47.19 ±5. 80）,（50.06 ±7.80） ,（36.12 ±4. 50） and（52. 38 ±4.95） HU. The CT value of the above corresponding parts regarding liver function classification （ A, B and C） were respectively （39. 57 ± 4. 56）, （36.56 ±5.46）, （31.24 ±5.23）, （45.23 ±6.73）, （40. 86 ±6.92）, （36.06 ±7.12）, （45. 97 ±6.07）, （42. 76 ±6. 35） and （38.67 ±7.35）,（37.33 ±4.09）,（33.46±3.97）,（28.23 ±4.13）,（48.66 ±4.38）,（45.03 ±4.43）and（40.12 ±5.32）HU. Va-riance analysis showed that there were statistical differences in the CT values of the portal vein, abdominal aorta, pancreas, double kid-neys and spleen between the portal hypertension group and the normal group （ P 〈 0. 05）. There was also statistical significance in the above corresponding parts regarding liver function classification （ A, B and C ）. Conclusion In case of portal hypertension, the CT val-ues of the portal vein, the abdominal aorta, the pancreas, the double kidneys and the spleen would decrease, and the higher the liver function classification, the lower the CT values, indicating that portal hypertension had certain effects on the function of peripheral or-gans and hemodynamics of aorta.