摘要
目的通过多排螺旋CT门静脉成像(CTPV)来探讨PV管径与肝硬化严重程度及食管胃底静脉曲张出血的关系;分析不同肝硬化程度下食管胃底静脉曲张出血的发生情况。方法肝硬化组(n=60)按Child-Pugh分级分为A级29例,B级23例,C级8例,按食管胃底静脉曲张有无出血分为出血组(n=30)和未出血组(n=30),所有患者均行CTPV检查,采用最大密度投影(MIP)、容积再现(VR)及多平面重建(MPR)多种方法来测量PV(PV)分支及各属支的管径和观察门脉高压侧支循环的影像学特征。另选15例正常体检者记为正常对照组。结果通过测量所有肝硬化患者的PV主干(MPV)、PV肝内分支及其属支胃左静脉(LGV)、脾静脉(SPV)和肠系膜上静脉(SMV)的管径,除PV右支(RPV)及SMV的直径在出血组与未出血组间差异无统计学意义外,其余各管径[PV左支(LPV)、PV、LGV及SV]在两组间差异均有统计学意义(P<0.05);肝硬化Child-Pugh A、B、C3组与正常对照组比较,PV系统管径差异均有统计学意义(P<0.05)。在不同肝硬化程度下,各组管径有不同的差异性,Child-Pugh A、B、C 3组间的出血率差异有统计学意义(P<0.05),随着Child-Pugh分级的增大,出血率不断增高。结论出血组中的PV系统的管径较未出血组大;不同肝硬化程度下各组PV肝内分支和属支与正常对照组有显著的差异性,各组管径在不同肝硬化分级下也不相同,因而不同的肝硬化程度可以预测食管胃底静脉曲张的出血率。
Objective To discuss the relationship between the diameter of portal vein and esophagogastric variceal bleeding and the severity of liver cirrhosis by CT portal venography （CTPV）. To analyze the occurence about esophagogastric variceal bleeding under in different liver cirrhosis degree. Methods 60 patients of portal hypertension with liver cirrhosis and 15 healthy volunteers （controls）. According to Child-Pugh classification, 60 patients were divided into Child-Pugh A, B and C groups, According to the patients whether the esophagogastric variceal bleeding or not, it was divided into two groups that esophagogastric variceal bleeding （EVB） and no EVB. All of patients underwent with 64-slice spiral CT. Image post-processing techniques such as MIP, VR, MPR and SSD were applied to measuring the diameters of portal venous system vessels and depict the portosystemic collaterals of portal venous system. Results The diameters of the right branch of portal vein and super mesenteric vein were no statistical significance between bleeding group and no bleeding group. The rest parameters of portal system in EVB group are all larger than those of no EVB group （ P 〈 0.05 ）. Age and gender in two groups had no statistic significance. All diameters of portal system in cirrhotic group were all larger than those of control group （P 〈 0. 05 ）. In different liver function, there are differences in each groups of diameter. The bleeding rate of different groups according to hepatic function showed statistical significance （P 〈 0. 05 ）, higher the degree of liver cirrhosis, higher the bleeding rate. Conclusion The diameters of portal system in EVB group are larger than no EVB. All diameters of portal system in cirrhotic group are all larger than those of control group. There is difference the diameter of vascular in different hepatic function. Different degree of liver cirrhosis can predict the esophagogastric variceal bleeding.
出处
《安徽医科大学学报》
CAS
北大核心
2013年第11期1376-1379,共4页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技厅年度重点课题(编号:12070403057)
关键词
肝硬化
门脉高压
食管胃底静脉曲张
多排螺旋
CT
liver cirrhosis
portal hypertension
esophageal and gastric varices
muhi-deector row spiral CT
