CT和MR测量肝尾状叶与肝右叶比值评估乙肝肝硬化程度

CT and MR were used to measure the ratio of caudate lobe to right lobe to evaluate the degree of hepatitis B cirrhosis

[目的]探讨CT和MR测量改良肝尾状叶与肝右叶比值(C/RL-r)在诊断乙肝肝硬化并评估硬化程度中的价值。[方法]选取2018年5月1日~2020年4月30日住院治疗的138例乙肝肝硬化患者为研究对象,随机分为CT检查组、MR检查组和联合检查组,同期选取行健康体检的56例受试者纳入研究,随机分配为CT与MR检查组,扫描后进行C/RL-r计算,比较其在患者与健康人群间的差异,并分别分析在CT和MR测量组中其与肝硬化程度及相关指标的相关关系。[结果]CT和MR测量的A级肝硬化患者C/RL-r分别为1.23±0.31、1.19±0.23,健康体检人群CT和MR测量C/RL-r分别为0.79±0.23、0.81±0.19,组间比较差异有统计学意义(P<0.05);肝硬化ROC曲线显示CT诊断肝硬化在0.97的最佳截断点时特异度和灵敏度分别为80.13%和81.46%,MR诊断肝硬化在0.99的最佳截断点时特异度和灵敏度分别为82.42%和79.52%,两者联合检测的特异度与灵敏度为85.57%和83.61%;不同肝硬化程度CT和MR测量的C/RL-r差异有统计学意义,其中且C级>B级>A级(均P<0.05);C/RL-r值与肝硬化主要指标相关性分析结果显示,HA、IVC、LN、脾脏大小、肝硬度值、门静脉宽度均与C/RL-r值呈正相关(均P<0.05)。[结论]C/RL-r与肝硬化程度和相关指标密切相关,作为一种非侵入性检查方法,CT和MR测量C/RL-r对诊断乙肝肝硬化具有重要的参考价值与意义,联合诊断更能提高准确性。

[Objective]To explore the value of CT and MR in the diagnosis of hepatitis b cirrhosis and the assessment of the degree of cirrhosis.[Methods]One hundred and thirty-eight patients with hepatitis B cirrhosis who were admitted to our hospital’s infection department for inpatient treatment from May 1,2018 to April 30,2020 were selected as the research objects,and were randomly divided into CT examination group,MR examination group and combined examination group,and selected at the same time 56 patients who underwent health checkups in our hospital were included in the study and randomly assigned to CT and MR examination groups.After scanning,C/RL-r was calculated and the differences between patients and healthy people were compared and analyzed in CT and MR measurements respectively.The relationship between it and the degree of liver cirrhosis and related indicators in the group.[Results]The C/RL-r measured by CT and MR in patients with grade A liver cirrhosis were 1.23±0.31 and 1.19±0.23,respectively,and the C/RL-r measured by CT and MR in healthy people were 0.79±0.23,0.81±0.19,the difference between the groups was statistically significant(P<0.05);the ROC curve of liver cirrhosis showed that the specificity and sensitivity of CT diagnosis of liver cirrhosis at the best cut-off point of 0.97 were 80.13% and 81.46%,respectively.MR The specificity and sensitivity of diagnosing liver cirrhosis at the best cut-off point of 0.99 are 82.42% and 79.52%,respectively,and the specificity and sensitivity of the combined detection of the two are 85.57% and 83.61%;CT and MR measurements of different degrees of cirrhosis The difference in C/RL-r was statistically significant,among which C>B>A(all P<0.05);the correlation analysis results between C/RL-r value and the main indicators of liver cirrhosis showed that HA,IVC,LN,Spleen size,liver stiffness value,portal vein width are positively correlated with C/RL-r value(all P<0.05).[Conclusion]C/RL-r is closely related to the degree of liver cirrhosis and related indicators.As a non-invasive examination method,CT and MR measurement of C/RL-r have important reference value and significance for the diagnosis of hepatitis B cirrhosis,and combined diagnosis is more effective Improve accuracy.