肝硬化的CT分型

CT Grouping of Liver Cirrhosis

目的:探讨肝硬化的CT分型标准及其临床意义。材料和方法:根据357例肝硬化患者的CT表现进行CT分型,分析各型肝硬化的肝脏大小、密度及脾脏增大、侧支静脉曲张、腹水、胸腔积液、肝癌、胆囊结石等并发症情况。结果:357例肝硬化患者被分为3个CT类型:均匀型(87例,占24.4％)、节段型(41例,占11.5％)和结节型(229例,占64.1％)。均匀型中肝脏缩小显著少于另两型(P<0.001);12例(13.8％)肝脏密度低于脾脏,显著多于结节型的4.4％(P<0.01)。脾脏肿大程度显著轻于节段型和结节型(P<0.01和0.001)。节段型发生侧支静脉曲张的比率最高(29例,70.7％),其次为结节型(39例,17.0％)和均匀型(2例,2.3％),各组间均有显著差异(P<0.001)。结节型中79.5％病例有腹水,显著多于节段型26.8％和均匀型10.3％(P均<0.001),节段型又显著多于均匀型(P<0.025);21.4％的结节型病例有胸膜腔积液,显著多于节段型的7.3％(P<0.05)和均匀型的4.6％(P<0.001)。结节型病例中原发性肝癌的发病率为29.7％(68例),显著高于节段型的2.4％和均匀型的5.7％(P均<0.001)。结论:不同CT类型的肝硬化与其并发症间存在着一定关系,对临床上肝脏储备功能和预后的判断具有提示作用。

Purpose: To probe into the criterion of CT grouping of liver cirrhosis and its significance. Materials and Methods: On the basis of CT findings in 357 cases with liver cirrhosis, CT grouping of cirrhosis was performed.The size and density of liver and complications, including enlargement of spleen, varieose collateral veins, ascites, pleurorrhea, primary liver carcinoma, gallbladder stone, etc, of all groups were analyzed. Results: Three hundred and fifty seven cases with cirrhosis were divided into three CT groupings, homogeneous group(87 cases, 24.4%), segmental group (41 cases, 11.5%) and nodal group (229 cases, 64.1%) .In homogeneous group, the cases with shrink liver were significantly less than that in other groups(P < 0.001), the number of the low density of liver in 12 cases(13.8% ) were significantly more than that in nodal group (4.4%) (P < 0.01) and the grade of spleen enlargement was significantly less than that in segmental and nodal group(P < 0.01 and 0.001). The incidence of varices in segmental group was the most (70.7%), in nodal group next(17.0%) and in homogeneous group the least(2.3%)(P < 0.001). In nodal group, ascites was in 182 cases(79.5% ) significantly more than that in segmental(26.8% ) and homogeneous group(0.3%) (P<0.001), then the former more than the latter(P< 0.025), and pleurorrhea was in 49 cases (21.4%) significantly more than that in segmental(7.3% )(P < 0.05) and homogeneous group (4.6%) (P<0.001) . There were 68 cases(29. 69%) with primary liver carcinoma in the nodal group, and significantly more than that in other tow groups(P < 0.001). Conclusion: There is some relation between the CT groupings of the liver cirrhosis and its complications. The practice of the grouping gives a hint for estimating stand - by capacity of liver and prognosis.