多层螺旋CT门静脉成像在肝硬化中医证型诊断中的应用研究

A Study on Application of Multi-Slice Spiral CT Portal Vein Imaging in the Diagnosis of Chinese Medicine Syndrome Types of Cirrhosis

目的:评估多层螺旋CT门静脉成像检查实施于肝硬化患者中医证型诊断中的效果。方法:将2017年2月—2019年3月诊断为乙肝肝硬化的患者60例纳入研究,所有患者进行中医证型诊断,将30例气滞瘀阻型患者归入气滞瘀阻组,30例其他中医证型患者归入非气滞瘀阻组,2组均实行多层螺旋CT门静脉成像检查。计算2组门静脉强化峰值延长时间、肝脏最高密度差数值、门静脉分支积分、轮廓边界积分,以及兴趣区门静脉灌注量、肝脏动脉灌注量、总肝灌注量。结果:气滞瘀阻组门静脉强化峰值延长时间、肝脏最高密度差数值高于非气滞瘀阻组(P<0.05);气滞瘀阻组门静脉分支积分、轮廓边界积分高于非气滞瘀阻组(P<0.05);气滞瘀阻组兴趣区门静脉灌注量、肝脏动脉灌注量、总肝灌注量低于非气滞瘀阻组(P<0.05)。结论:在肝硬化患者中医证型诊断中,采用多层螺旋CT门静脉成像检查可提供辨证依据。

Objective: To evaluate the effect of multi-slice spiral CT portal vein imaging on the diagnosis of Chinese medicine syndrome types in patients with cirrhosis. Methods:Sixty patients with hepatitis B cirrhosis from February 2017 to March 2019 were included in the study, and were differentiated into different Chinese medicine syndrome types. Thirty patients of qi stagnation and stasis obstruction type were classified into the qi stagnation and stasis obstruction group,and 30 patients of other Chinese medicine syndrome types were classified into the non-qi stagnation and stasis obstruction group.Multi-slice spiral CT portal vein imaging was performed in both groups to calculate the peak duration of portal vein enhancement, the difference in maximum liver density, integral value of portal vein branch, integral value of contour boundary,perfusion volume of portal vein in the region of interest,perfusion volume of hepatic artery,and total hepatic perfusion volume in the two groups. Results:The peak duration of portal vein enhancement and the difference in maximum liver density in the qi stagnation and stasis obstruction group were larger than those in the non-qi stagnation and stasis obstruction group(P<0.05). The integral value of portal vein branch and integral value of contour boundary in the qi stagnation and stasis obstruction group were larger than those in the non-qi stagnation and stasis obstruction group(P<0.05). The perfusion volume of portal vein in the region of interest, perfusion volume of hepatic artery, and total hepatic perfusion volume in the qi stagnation and stasis obstruction group were smaller than those in the non-qi stagnation and stasis obstruction group(P<0.05). Conclusion: Multi-slice spiral CT portal vein imaging can provide the basis of syndrome differentiation for the diagnosis of Chinese medicine syndrome types in patients with cirrhosis.