腹部CT检查参数预测肝硬化门静脉高压症患者并发食管胃底静脉曲张价值研究*

doi:10.3969/j.issn.1672-5069.2026.04.022

摘要/Abstract

摘要： 目的评估腹部CT检查参数预测肝硬化门静脉高压症患者并发食管静脉曲张(EV)/胃底静脉曲张(GV)的临床价值。方法 2021年1月～2025年12月我院诊治的 110 例肝硬化并发门静脉高压症患者,行纤维电子胃镜检查诊断静脉曲张,接受腹部 CT 扫描检查测量肝脾实质碘浓度和胃冠状静脉直径。应用受试者工作特征曲线(ROC)评估诊断效能。结果在110例肝硬化患者中,胃镜检查发现并发轻度EV者61例,中重度EV/GV者49例;中重度EV/GV组肝左叶、右叶、尾状叶和脾实质碘浓度及胃冠状静脉直径分别为(5.9±1.1)mg/ml、(5.6±0.7)mg/ml、(6.1±0.9)mg/ml、(20.4±1.5)mg/ml和(5.5±0.8)mm,均显著高于或大于轻度组【分别为(5.1±0.7)mg/ml、(5.0±0.4)mg/ml、(5.5±0.5)mg/ml、(17.7±1.2)mg/ml和(3.6±0.5)mm,P＜0.05】;以胃冠状静脉直径≥4.7 mm、肝尾状叶碘浓度≥5.8 mg/ml和脾实质碘浓度≥19.2 mg/ml为联合诊断中重度EV/GV的截断点,结果 CT检查诊断中重度EV/GV的灵敏度为77.6%,特异度为83.6%,准确度为80.9%。结论腹部CT检查评估肝硬化门静脉高压症患者并发EV具有较高的辅助诊断价值。

关键词: 肝硬化, 门静脉高压症, 食管/胃底静脉曲张, 纤维电子胃镜, CT扫描, 诊断

Abstract: Objective The purpose of this study was to investigate prediction of esophageal gastric varices (EV/GV) by abdominal CT scan parameters in patients with liver cirrhosis (LC) and portal hypertension. Methods 110 patients with LC and portal hypertension were encountered in our hospital between January 2021 and December 2025, and all patients underwent electronic gastroscopy. Abdominal CT scan was conducted to measure hepatic and splenic parenchyma iodine concentrations, and gastric coronary vein (GCV) diameter. Predicting efficacy was evaluated by receiver operating characteristic (ROC) curve. Results Of the 110 patients with LC, gastroscopy found mild EV in 61 cases, and moderate to severe EV/GV in 49 cases; iodine concentrations in left lobe, right lobe, caudate lobe of the liver, and splenic parenchyma as well as diameter of GCV in patients with moderate to severe EV/GV were (5.9±1.1)mg/ml, (5.6±0.7)mg/ml, (6.1±0.9)mg/ml, (20.4±1.5)mg/ml and (5.5±0.8)mm, all significantly higher or greater than [(5.1±0.7)mg/ml, (5.0±0.4)mg/ml, (5.5±0.5)mg/ml, (17.7±1.2)mg/ml and (3.6±0.5)mm, respectively, P＜0.05] in those with mild EV; the sensitivity, specificity and accuracy were 77.6%, 83.6% and 80.9%, when diameter of GCV≥4.7 mm, iodine concentrations in caudate lobe of liver≥5.8 mg/ml and splenic parenchyma≥19.2 mg/ml were set as the cut-off-value in predicting moderate to severe EV/GV. Conclusion Abdominal CT scan could help judge EV/GV existence in patients with LC.

Key words: Liver cirrhosis, Portal hypertension, Esophageal gastric varices, Endoscopy, Abdominal CT scan, Diagnosis

赖振辉, 蔡银连, 崔东, 文峥. 腹部CT检查参数预测肝硬化门静脉高压症患者并发食管胃底静脉曲张价值研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 565-568.

Lai Zhenhui, Cai Yinlian, Cui Dong, et al. Prediction of esophageal gastric varices by abdominal CT scan parameters in patients with liver cirrhosis and portal hypertension[J]. Journal of Practical Hepatology, 2026, 29(4): 565-568.

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腹部CT检查参数预测肝硬化门静脉高压症患者并发食管胃底静脉曲张价值研究^*

Prediction of esophageal gastric varices by abdominal CT scan parameters in patients with liver cirrhosis and portal hypertension

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