64层螺旋CT门静脉造影对肝硬化患者肝功能分级和食管静脉曲张破裂出血的预测价值*

doi:10.3969/j.issn.1672-5069.2014.03.016

Abstract

Abstract: Objective To assess the clinical value of 64-slice spiral CT portography in prediction of esophageal variceal bleeding （EVB） in cirrhotic patients. MethodsSixty four patients with liver cirrhosis （30 cases with EVB, and 34 without） and 36 normal persons underwent 64-slice spiral CT portography and the diameters of the main portal vein （MPV）,splenic vein （SPV）,left gastric vein （LGV）,intrahepatic left portal vein （IHLPV） and intrahepatic right portal vein（IHRPV） were measured; The ability of these indexes in prediction of EVB were evaluated by the area under the receiver operating characteristic （ROC） curves （AUC）. Results The diameters of MPV,SPV,LGV,IHLPV and IHRPV in cirrhotic patients were （1.68±0.21） cm,（45±0.18） cm,（0.53±0.12） cm,（1.21±0.15） cm and（1.26±0.22） cm,respectively, significantly higher than those in the controls[（1.18±0.14） cm,（0.80±0.09） cm,（0.42±0.07） cm,（0.95±0.07） cm and （0.96±0.11） cm,respectively,P<0.05];The diameters of MPV,SPV,LGV,IHLPV and IHRPV in patients with Child-Pugh class C were（2.01±0.20）cm,（1.57±0.10） cm,（0.59±0.11）cm,（1.36±0.09） cm and（1.45±0.12） cm,respectively,significantly higher than those in patients with Child-Pugh class A[（1.68±0.15）cm,（1.35±0.13）cm,（0.48±0.09）cm,（1.11±0.13）cm and （1.15±0.21）cm,respectively,P<0.05];The diameters of MPV,SPV,LGV and IHLPV in EVB group were（1.78±0.16） cm,（1.54±0.20）cm,（0.62±0.10）cm and（1.28±0.15）cm,respectively,significantly higher than those in patients without EVB[（1.60±0.21）cm,（1.36±0.13）cm,（0.45±0.06）cm and（1.15±0.13）cm,respectively,P<0.05];The diameter of IHRPV showed no difference between patients with EVB （1.29±0.21）cm and without EVB （1.25±0.23）cm;The AUC of LGV was 0.906,and the sensitivity and specificity in prediction of EVB were 93.3% and 58.8%, respectively when LGV was greater than 0.61 cm. Conclusion 64-slice spiral CT portal venography can not only clearly show the collateral vessels of portal hypertension in cirrhotic patients,but also has a certain value in prediction of EVB in clinical practice.

Key words: Cirrhosis, Esophageal varices, 64-slice spiral CT, Portography

Liu Wenna, Hao Tingting, Wang Jian. Prediction of esophageal variceal bleeding with 64-slice spiral CT portography in cirrhotic patients[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(3): 283-287.

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Prediction of esophageal variceal bleeding with 64-slice spiral CT portography in cirrhotic patients

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