多层螺旋计算机断层扫描门静脉成像对肝硬化所致门静脉高压症合并食管-胃底静脉曲张的术前诊断价值

Preoperative diagnostic value of multi-slice spiral computed tomography portography in cirrhotic portal hypertension complicated with esophago-gastric fundal varices

目的探讨多层螺旋计算机断层扫描门静脉成像(MSCTP)对肝硬化所致门静脉高压症合并食管-胃底静脉曲张(EGV)的术前诊断价值。方法收集2019年6月至2021年3月武汉市第八医院武汉市肛肠医院收治的130例肝硬化所致门静脉高压症合并EGV患者的临床资料,以内镜检查结果为金标准,评估MSCTP对肝硬化所致门静脉高压症合并的EGV的诊断价值及对EGV分级与分型结果与内镜检查结果的一致性。结果内镜检查结果显示,130例患者中,合并EGV患者为91例,未合并EGV患者为39例。MSCTP诊断EGV的灵敏度为93.42%,特异度为87.18%,准确度为91.54%,具有较高的诊断价值[曲线下面积(area under the curve,AUC)=0.903],诊断结果与内镜检查结果具有较高的一致性(Kappa=0.800,P<0.05)。MSCTP对EGV分级、分型的诊断结果与内镜检查结果均具有较高的一致性(Kappa=0.765、0.806,P<0.05)。结论MSCTP对肝硬化所致门静脉高压症合并EGV具有较高的诊断价值,对EGV分级与分型的诊断结果与内镜检查结果具有较高的一致性,可为肝硬化所致门静脉高压症合并EGV的分级、分型及临床疗效提供可行性参考。

Objective To investigate the preoperative diagnostic value of multi-slice spiral computed tomography portography(MSCTP)in cirrhotic portal hypertension complicated with esophago-gastric fundal varices(EGV).Method Clinical data of 130 patients cirrhotic portal hypertension complicated with EGV caused by cirrhosis who were admitted in the Eighth Hospital of Wuhan(the Anorectal Hospital of Wuhan)from June 2019 to March 2021 were collected.The diagnostic value of MSCTP for cirrhotic portal hypertension complicated with EGV caused by cirrhosis and the consistency of degree and typing of EGV with endoscopic examination as the gold standard were analyzed.Result Among the 130 patients diagnosed by endoscopy,91 patients had EGV,and 39 patients did not have EGV.The sensitivity,specificity and accuracy of MSCTP in diagnosing EGV were 93.42%,87.18% and 91.54%,which had high diagnostic value[area under the curve(AUC)=0.903]and consistency with endoscopic examination(Kappa=0.800,P<0.05).MSCTP showed a high consistency for EGV degree and typing results with endoscopic results(Kappa=0.765,0.806,P<0.05).Conclusion MSCTP for cirrhotic portal hypertension complicated with EGV has high diagnostic value,has high consistency for EGV degree and typing with endoscopic results,which can provide feasible reference for EGV degree,typing and clinical efficacy of cirrhotic portal hypertension complicated with EGV.