肝小静脉闭塞病的CT诊断研究

发布时间：2018-02-02 08:21

本文关键词： 肝小静脉闭塞病布加综合征肝炎后肝硬化数字减影血管造影　出处：《大连医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：收集肝小静脉闭塞病(hepatic veno-occlusive disease，HVOD)10例、布加综合征（Budd-chiari Syndrome，BCS）10例、肝炎后肝硬化20例，测量其门静脉主干直径等，以判断3组间是否有统计学差异。分析10例HVOD患者CT征象，并将其CT门静脉三维重建表现与数字减影血管造影(digital subtractionangiography，DSA)进行对比性研究，探讨CT检查及其后处理重建技术在HVOD诊断及其鉴别诊断中的应用价值。材料与方法：回顾性分析了3组患者（HVOD10例、BCS10例、肝炎后肝硬化20例）临床及影像资料。①观察3组患者CT平扫及其增强表现，包括三维重建后影像学特征，以及3组疾病侧支循环情况等；其中HVOD组CT三维重建表现与DSA影像相对比。②测量HVOD患者门静脉主干直径与正常值进行比较；③测量3组受检者的门静脉主干、左右支、脾静脉直径，应用成组设计方差分析（ANOVA），并进一步应用（LSD-t检验）进行两两对比，观察是否有统计学意义；④收集做CT及DSA的患者30例患者，观察（CT测量）门静脉直径与（DSA）门静脉压力有无相关。结果：①CT三维重建与DSA图像相符合（门静脉、侧支循环方面），肝静脉显示方面，DSA优于CT；侧支循环显示情况：平均HVOD组：1.2支，BCS组：2.5支，肝炎后肝硬化组：2.1支。②HVOD患者门静脉主干平均值，比正常值略低；③门静脉左支、右支:HVOD与BCS组(LSD-t检验)之间无统计学差异。其余门静脉主干、左右支、脾静脉，3组间两两比较，两组间对比有统计学意义（P0.05）；④CT测量门静脉直径与DSA测量的门静脉压力之间无相关。结论：首先，CT增强扫描可以将典型的HVOD、BCS患者，，与肝炎后肝硬化鉴别开来。而CT三维重建技术可以对HVOD与BCS进行进一步的鉴别，其次，三维重建中门静脉直径、侧支循环情况等，与DSA相符合，可以对疾病进行辅助性诊断。最后，详细了解病史、临床表现、实验室检查、其他辅助检查等一般资料，在鉴别诊断中也占有十分重要的地位。总之，CT检查对HVOD的诊断及其与BCS、肝炎后肝硬化的鉴别诊断有一定的临床价值。
[Abstract]:Objective: to collect 10 cases of hepatic veno-occlusive disease (veno-occlusive) with HVODN. The diameter of portal vein trunk was measured in 10 cases of Budd-chiari Syndrometerus syndrome and 20 cases of posthepatitic cirrhosis. In order to judge whether there were statistical differences among the three groups, the CT signs of 10 cases of HVOD were analyzed. The CT portal vein 3D reconstruction was compared with digital subtraction angiography (DSA). To evaluate the value of CT and post-processing reconstruction in the diagnosis and differential diagnosis of HVOD. Materials and methods: the clinical and imaging data of 10 patients with HVOD10 patients with BCS and 20 patients with posthepatitic cirrhosis were retrospectively analyzed. The imaging features after 3D reconstruction and collateral circulation in 3 groups were included. Ct 3D reconstruction in HVOD group was compared with DSA imaging. 2 the diameter of portal vein in HVOD patients was measured and the normal value was compared. 3The diameter of portal vein, left and right branches and splenic vein were measured in 3 groups. ANOVAN was used to design ANOVAN in group, and LSD-t test was used to make a pairwise comparison. Observe whether there is statistical significance; 4Thirty patients with CT and DSA were collected. The diameter of portal vein was measured by CT. Results Three-dimensional reconstruction of 1: 1 CT was consistent with DSA images (portal vein, collateral circulation, hepatic vein display). Collateral circulation: the mean value of portal vein trunk in HVOD group was slightly lower than that in normal group, and the mean value of portal vein trunk was slightly lower in HVOD group (1: 1.2 branch) than in control group (2: 2.5 branches) and in posthepatitic cirrhosis group (1. 1 branch 路2. 2 HVOD group). 3There was no significant difference between the left portal vein, the right branch and the BCS group (LSD-t test), but the other portal vein trunk, left and right portal vein, splenic vein were compared in two groups. There was significant difference between the two groups (P 0.05). 4 there was no correlation between the diameter of portal vein measured by CT and the pressure of portal vein measured by DSA. Conclusion: first of all, enhanced CT scan can be used in typical patients with HVODV BCS. Ct 3D reconstruction can be used to differentiate HVOD from BCS. Secondly, the diameter of portal vein and collateral circulation in 3D reconstruction can be further distinguished. In accordance with DSA, we can make auxiliary diagnosis of the disease. Finally, we can understand the history, clinical manifestation, laboratory examination, other auxiliary examination and other general data in detail. All in all, CT examination has certain clinical value in the diagnosis of HVOD and the differential diagnosis of posthepatitic cirrhosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.5;R575

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