CT门静脉成像在肝硬化食管胃静脉曲张中的应用价值

发布时间：2018-03-04 07:18

本文选题：肝硬化　切入点：食管和胃静脉曲张　出处：《胃肠病学》2016年10期 　论文类型：期刊论文

【摘要】：背景:CT门静脉成像(CTP)可直观地显示门静脉及其侧支循环,为临床常用的门静脉高压评估方法。目的:评价CTP在肝硬化食管胃静脉曲张中的应用价值。方法:回顾性收集2013年1月—2015年9月在青岛大学附属医院行CTP和胃镜检查并符合纳入标准的肝硬化患者143例,根据入院时有无消化道出血分为出血组(n=70)和未出血组(n=73)。采用Kappa一致性检验分析CTP与胃镜检查结果的一致性,采用ROC曲线分析CTP参数门静脉主干(MPV)、脾静脉(SPV)、胃左静脉(LGV)直径预测食管胃静脉曲张破裂出血的准确性。结果:CTP与胃镜检查判断食管胃静脉曲张的分型、分级一致性较好(κ=0.793,0.775)。出血组MPV、SPV、LGV直径均显著宽于未出血组(P0.01),三者预测食管胃静脉曲张破裂出血的ROC曲线下面积(AUC)分别为0.741、0.627和0.816,LGV直径的准确性最高,以6.1 mm为界值,其敏感性和特异性分别为65.71%和84.93%;MPV直径以16.3 mm为界值时,敏感性(75.71%)优于LGV和SPV。结论:CTP可用于肝硬化食管胃静脉曲张的临床诊断,其参数LGV、MPV直径有助于静脉曲张破裂出血的预测。
[Abstract]:Background: Ct portal vein imaging (CTP) can visualize portal vein and its collateral circulation. Objective: to evaluate the value of CTP in evaluating portal hypertension in patients with cirrhosis of esophagus and stomach varices. Methods: from January 2013 to September 2015, CTP and gastroscopy were performed at the affiliated Hospital of Qingdao University. 143 patients with liver cirrhosis were examined and met the inclusion criteria. According to whether there was gastrointestinal hemorrhage on admission, the patients were divided into two groups: hemorrhage group (n = 70) and non-bleeding group (n = 73). The consistency between CTP and gastroscopy was analyzed by Kappa consistency test. The ROC curve was used to analyze the accuracy of predicting the bleeding of esophageal and gastric varices with the diameter of CTP parameters, such as the main portal vein, the splenic vein, and the left gastric vein. Results the types of esophageal and gastric varices were determined by using ROC and gastroscopy. The classification consistency was good (魏) 0.793n 0.7750.The diameter of MPV in bleeding group was significantly wider than that in non-bleeding group (P 0.01). The area under the ROC curve for predicting esophageal and gastric variceal bleeding was 0.741v 0.627 and 0.816m respectively, with 6.1 mm as the boundary value. Its sensitivity and specificity were 65.71% and 84.93 mm, respectively, and the sensitivity was 75.71% when the diameter of MPV was 16.3 mm. Conclusion LGV and SPV can be used in the clinical diagnosis of esophageal and gastric varices in cirrhosis, and its parameters can be used to predict the bleeding of variceal rupture.
【作者单位】：青岛大学医学部;山东大学齐鲁医院(青岛)病理科;青岛大学附属医院消化内科;
【分类号】：R575.2

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