瞬时弹性成像技术在肝硬化门静脉高压患者中的诊断及预后评估价值

The diagnostic and prognostic value of transient elastography in cirrhotic patients with portal hypertension

目的探讨瞬时弹性成像技术在肝硬化门静脉高压患者中的诊断及预后评估价值。方法选取2019年3月至2021年3月本院影像科收治的120例肝硬化患者作为研究对象,按照有无食管静脉曲张及曲张严重程度分为无曲张组(n=40)、轻度曲张组(n=20)、中度曲张组(n=25)、重度曲张组(n=35),所有患者均采用瞬时弹性成像技术测量肝硬度、脾硬度,采用腹部超声测量门静脉主干内径及脾厚度。比较4组肝硬度、脾硬度、门静脉主干内径、脾厚度,分析肝、脾硬度与门静脉主干内径、脾厚度的相关性,比较食管静脉曲张破裂不同出血次数患者肝硬度、脾硬度。结果4组肝硬度、脾硬度和门静脉主干内径、脾厚度组间两两比较差异有统计学意义(P<0.05),随着曲张严重程度的加重,患者肝硬度、脾硬度逐渐增加,门静脉主干内径逐渐变大,脾厚度逐渐增厚(P<0.05)。肝硬度、脾硬度与门静脉主干内径、脾厚度均呈正相关(r>0,P<0.05)。未破裂出血患者肝硬度、脾硬度均小于出血1次和出血多次患者,且出血1次患者小于出血多次患者(P<0.05)。结论瞬时弹性成像技术应用于肝硬化门静脉高压中具有较高的诊断价值,对预后评估有较大的参考意义。

Objective To investigate the diagnostic and prognostic value of transient elastography in cirrhotic portal hypertension patients.Methods A total of 120 patients with cirrhosis admitted to the department of Imaging of our hospital from March 2019 to March 2021 were selected as the research subjects,they were divided into non-varices group(n=40),mild varices group(n=20),moderate varices group(n=25)and severe vari-ces group(n=35)according to the presence or lack of esophageal varices and the severity of esophageal varices,instantaneous elastic imaging tech-nology was used to detect liver hardness and spleen hardness in all patients,and abdominal ultrasound was used to detect portal vein main diameter and spleen thickness.The hardness of liver,hardness of spleen,inner diameter of portal vein and spleen thickness were compared among the four groups,and the correlation between the hardness of liver and spleen and the inner diameter of the portal vein and spleen thickness was analyzed,and the hard-ness of liver and spleen was compared in patients with different bleeding times of esophageal varices rupture.Results There were statistically signif-icant pair differences in the hardness of liver and spleen,the inner diameter of portal vein and spleen thickness among the four groups,the differences were statistically significant(P<0.05),with the aggravation of varicose severity,the hardness of the liver and spleen gradually increased,the inner diameter of the main portal vein gradually larger,and spleen thickness gradually thickened,and the differences were statistically significant(P<0.05).The hardness of liver and hardness were positively correlated with the inner diameter of the main portal vein and spleen thickness(r>0,P<0.05).The hardness of liver and spleen in patients with unruptured bleeding were smaller than those in patients with one or multiple bleeding,and the hardness of liver and spleen in patients with one bleeding was smaller than that in patients with multiple bleeding,the difference was statistically sig-nificant(P<0.05).Conclusion Transient elastic imaging technique has high diagnostic value in portal hypertension of cirrhosis and has great refer-ence significance for prognosis evaluation.