能谱CT评估肝硬化食管静脉曲张程度的价值研究

发布时间：2018-01-16 10:14

本文关键词：能谱CT评估肝硬化食管静脉曲张程度的价值研究　出处：《临床放射学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的通过能谱CT碘基值与胃镜下食管静脉曲张(EV)程度进行比较,探讨能谱CT碘基值能否评估EV程度及出血风险,为临床治疗提供重要参考价值。方法 42例肝硬化患者分别进行能谱CT扫描及胃镜检查,分别记录动脉期、静脉期肝左叶、肝右叶、尾状叶、腹主动脉、门静脉、胃左静脉碘基值及胃镜下EV程度。胃镜下无、轻度EV为曲张非严重组,中、重度EV为曲张严重组。比较肝硬化组不同肝功能分级之间及胃镜下EV不同组别之间动/静脉期标准化碘浓度(A/VNIC)、胃左静脉指数(LGI)差异。绘制ROC曲线。结果肝硬化Child-C级的ANIC较Child-A、B级高,分别为(0.09±0.04)、(0.05±0.02)。胃镜下EV严重组较非严重组VNIC低,分别为(0.36±0.04)、(0.42±0.07);LGI高,分别为(1.04±0.16)、(0.76±0.31)。胃镜下严重胃底静脉曲张(GV)组较非严重曲张组LGI高,分别为(1.04±0.10)、(0.89±0.29)。出血组较未出血组VNIC低,分别为(0.36±0.04)、(0.42±0.08);LGI高,分别为(1.02±0.17)、(0.76±0.32)。LGI临界值为0.86时,ROC曲线下面积为0.84,诊断严重EV敏感性为92%,特异性为80%。LGI临界值为0.95时,ROC曲线下面积为0.73,诊断严重GV敏感性为92%,特异性为62%。结论能谱CT胃左静脉指数可以用来评估EV程度及出血风险,进而减少频繁地胃镜随访,为临床治疗提供重要的参考价值。
[Abstract]:The energy spectrum CT iodine base value with endoscopic esophageal varices (EV) level were compared to explore value can evaluate EV degree and risk of bleeding CT iodine based spectrum, provides important reference value for clinical treatment. Methods 42 cases of patients with liver cirrhosis were CT spectrum scanning and gastroscope examination, were recorded in the arterial phase the left lobe of the liver, venous phase, right hepatic lobe, caudate lobe, abdominal aorta, portal vein and left gastric vein iodine base value and endoscopic EV. Under gastroscope, mild EV Song Zhang, non severe group, severe EV for severe varicose group. Liver cirrhosis group is different between grades and between endoscopic groups of EV intravenous period normalized iodine concentration (A/VNIC), left gastric vein index (LGI). The differences of ROC curve. The Child-C level of ANIC Child-A with liver cirrhosis, high grade B, respectively (0.09 + 0.04), (0.05 + 0.02). In EV group than in the non serious severe group VNIC, respectively. For (0.36 + 0.04), (0.42 + 0.07); LGI, respectively (1.04 + 0.16), (0.76 + 0.31). Severe endoscopic gastric varices (GV) group than in the non severe varicose group LGI, respectively (1.04 + 0.10), (0.89 + 0.29) hemorrhage. The low VNIC group than in non bleeding group, respectively (0.36 + 0.04), (0.42 + 0.08); LGI, respectively (1.02 + 0.17), (0.76 + 0.32).LGI critical value is 0.86, the area under the ROC curve was 0.84, the diagnosis of severe EV sensitivity was 92%, specificity was 80%.LGI critical a value of 0.95, the area under the ROC curve was 0.73, the diagnosis of severe GV sensitivity was 92%, specificity was 62%. CT conclusion spectrum of left gastric vein index can be used to evaluate the degree of EV and the risk of bleeding, thereby reducing the frequent endoscopic follow-up, provides an important reference for clinical treatment.

【作者单位】：上海交通大学医学院附属仁济医院放射科;上海交通大学医学院附属仁济医院消化科;
【分类号】：R575.2;R816.5
【正文快照】： 肝硬化食管静脉曲张破裂出血是肝硬化门静脉高压最常见的并发症。大约35%~80%的肝硬化患者有食管静脉曲张表现,其中30%的食管静脉曲张患者有出血史,70%的首次出血患者会发生再次出血[1]。因此,评估肝硬化患者食管静脉曲张程度及出血风险,进而对其行药物或内镜干预治疗在预防食

【共引文献】