多层螺旋CT门静脉成像在肝硬化中医证型诊断中的应用价值
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摘要
目的:探讨多层螺旋CT门静脉成像在肝硬化中医证型诊断的应用价值。方法:将80例患者根据中医分型分为气滞瘀阻型组,其他类型组,每组40例。所有患者均使用西门子64排128层螺旋CT进行肝脏增强扫描,比较2组门脉强化峰值延长时间、肝脏最大密度差值和门静脉图像,以及兴趣区灌注相关参数,如门静脉灌注量、肝脏动脉灌注量及总肝灌注量变化情况。结果:门脉强化峰值延长时间、肝脏最大密度差值治疗后2组比较,差异有统计学意义(P<0.05)。门静脉分支积分、轮廓边缘积分治疗后2组比较,差异有统计学意义(P<0.05)。门静脉灌注量、肝脏动脉灌注量及总肝灌注量治疗后2组比较,差异有统计学意义(P<0.05)。结论:多层螺旋CT门静脉成像检查可于一定程度上反映不同中医类型肝硬化特点,从而作为肝硬化辨证分型依据。
Objective:To explore the application value of multilayer spiral CT portal vein imaging in the diagnosis of TCM patterns of liver cirrhosis. Methods:Eighty patients were separated into the group of Qi stagnation and stasis blocking pattern and the group of other patterns according to TCM patterns, 40 cases each group. All the patients accepted enhanced liver scanning using 64-row 128-layer spiral CT. The changes of the extended time of portal enhancement peak value, liver maximum density difference, portal vein image and perfusion-related parameters of region of interest such as total hepatic perfusion, hepatic arterial perfusion, portal vein perfusion and others were compared between both groups. Results: The difference had statistical meaning in the comparison of the extended time of portal enhancement peak value and liver maximum density difference between both groups after treating(P<0.05). The difference was statistically significant in the comparisons of portal branch integral and contour edge scores between both groups after treating(P<0.05). The difference showed statistical meaning in the comparison of total hepatic perfusion, hepatic arterial perfusion, portal vein perfusion between both groups after treating(P<0.05). Conclusion:Multilayer spiral CT portal vein imaging could reflect the features of liver cirrhosis of different TCM patterns to some extent, therefore to provide the reference for syndrome differentiation of liver cirrhosis.
Objective:To explore the application value of multilayer spiral CT portal vein imaging in the diagnosis of TCM patterns of liver cirrhosis. Methods:Eighty patients were separated into the group of Qi stagnation and stasis blocking pattern and the group of other patterns according to TCM patterns, 40 cases each group. All the patients accepted enhanced liver scanning using 64-row 128-layer spiral CT. The changes of the extended time of portal enhancement peak value, liver maximum density difference, portal vein image and perfusion-related parameters of region of interest such as total hepatic perfusion, hepatic arterial perfusion, portal vein perfusion and others were compared between both groups. Results: The difference had statistical meaning in the comparison of the extended time of portal enhancement peak value and liver maximum density difference between both groups after treating(P<0.05). The difference was statistically significant in the comparisons of portal branch integral and contour edge scores between both groups after treating(P<0.05). The difference showed statistical meaning in the comparison of total hepatic perfusion, hepatic arterial perfusion, portal vein perfusion between both groups after treating(P<0.05). Conclusion:Multilayer spiral CT portal vein imaging could reflect the features of liver cirrhosis of different TCM patterns to some extent, therefore to provide the reference for syndrome differentiation of liver cirrhosis.
引文
[1]赵尚飞,冯琨,曲巧燕,等.CT门静脉成像在肝硬化食管胃静脉曲张中的应用价值[J].胃肠病学,2016,21(10):615-619.
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[3]胡海东,张见增.216例肝硬化门静脉高压症患者CT血管成像门静脉侧支血管表现研究[J].实用肝脏病杂志,2016,19(1):73-76.
[4]范元军,郝建成,王立宇,等.128排门静脉成像对门静脉高压食管胃底静脉曲张诊断的临床意义[J].医学综述,2014,20(23):4398-4400.
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[7]邢卫红,冯爱东,李若旭,等.CT平扫及增强检查肝硬化门静脉高压伴脾功能亢进的价值研究[J].生物医学工程与临床,2016,20(3):271-274.
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[10]李伟.多层螺旋CT门静脉成像评估肝硬化食管静脉曲张出血风险[J].胃肠病学和肝病学杂志,2014,22(12):1262-1266.
[11]梁萍,方华盛,陈更瑞.多层螺旋CT门静脉成像对门静脉高压症的诊断及分类价值[J].中国CT和MRI杂志,2015,13(2):47-57.
[12]陈清生,蔡吉勇,蒋兴红,等.多层螺旋CT门静脉成像对评价门静脉高压及肝硬化程度的价值[J].重庆医学,2015,45(28):3983-3985.
[13]李瑞雄,蒋仕伍,杨维珍.多层螺旋CT门静脉成像对肝硬化门脉高压侧支循环的诊断价值[J].中国临床新医学,2015,8(4):315-317.
[14]周亚生.肝硬化CT门静脉血管成像中门静脉侧支血管的临床表现分析[J].现代诊断与治疗,2015,25(24):5634-5635.
[15]刘桂安,陈思羽,赵师仲.多层螺旋CT门静脉成像在诊断和评价肝硬化食管胃底静脉曲张中的价值[J].华西医学,2014,29(8):1494-1496.
[16]陈丽娟.多层螺旋CT门静脉成像与内镜检查诊断肝硬化合并食管胃静脉曲张比较[J].医技与临床,2015,13(9):72-73.
[17]文戈,邓燕佳,刘恺,等.肝硬化患者多层螺旋CT门静脉成像最佳扫描时间的研究[J].临床放射学杂志,2015,32(8):1169-1174.
[18]严福华.肝硬化门静脉高压CT和磁共振成像的表现及研究进展[J].临床肝胆病杂志,2016,32(6):1079-1082.
[2]余继海,许戈良,马金良,等.CT门静脉成像分型个体化手术治疗在肝硬化门静脉高压症中的应用价值[J].中华肝脏外科手术学电子杂志,2016,5(3):135-140.
[3]胡海东,张见增.216例肝硬化门静脉高压症患者CT血管成像门静脉侧支血管表现研究[J].实用肝脏病杂志,2016,19(1):73-76.
[4]范元军,郝建成,王立宇,等.128排门静脉成像对门静脉高压食管胃底静脉曲张诊断的临床意义[J].医学综述,2014,20(23):4398-4400.
[5]陆丹羽,全显跃.多层螺旋CT灌注成像联合CT门静脉造影一站式扫描技术在肝硬化中的应用[J].中国全科医学,2015,18(24):2991-2996.
[6]张训平,翟锦添.多层螺旋CT静脉成像对肝硬化门脉高压侧支循环的诊断评价[J].临床医学工程,2016,23(2):137-138.
[7]邢卫红,冯爱东,李若旭,等.CT平扫及增强检查肝硬化门静脉高压伴脾功能亢进的价值研究[J].生物医学工程与临床,2016,20(3):271-274.
[8]赵尚飞,曲巧燕,宋明全.CT门静脉成像在肝硬化食管胃静脉曲张中的应用进展[J].胃肠病学和肝病学杂志,2017,26(1):14-16.
[9]刘克敏.多层螺旋CT静脉成像在肝硬化门静脉高压症中的应用[J].当代医学,2014,20(23):57-58.
[10]李伟.多层螺旋CT门静脉成像评估肝硬化食管静脉曲张出血风险[J].胃肠病学和肝病学杂志,2014,22(12):1262-1266.
[11]梁萍,方华盛,陈更瑞.多层螺旋CT门静脉成像对门静脉高压症的诊断及分类价值[J].中国CT和MRI杂志,2015,13(2):47-57.
[12]陈清生,蔡吉勇,蒋兴红,等.多层螺旋CT门静脉成像对评价门静脉高压及肝硬化程度的价值[J].重庆医学,2015,45(28):3983-3985.
[13]李瑞雄,蒋仕伍,杨维珍.多层螺旋CT门静脉成像对肝硬化门脉高压侧支循环的诊断价值[J].中国临床新医学,2015,8(4):315-317.
[14]周亚生.肝硬化CT门静脉血管成像中门静脉侧支血管的临床表现分析[J].现代诊断与治疗,2015,25(24):5634-5635.
[15]刘桂安,陈思羽,赵师仲.多层螺旋CT门静脉成像在诊断和评价肝硬化食管胃底静脉曲张中的价值[J].华西医学,2014,29(8):1494-1496.
[16]陈丽娟.多层螺旋CT门静脉成像与内镜检查诊断肝硬化合并食管胃静脉曲张比较[J].医技与临床,2015,13(9):72-73.
[17]文戈,邓燕佳,刘恺,等.肝硬化患者多层螺旋CT门静脉成像最佳扫描时间的研究[J].临床放射学杂志,2015,32(8):1169-1174.
[18]严福华.肝硬化门静脉高压CT和磁共振成像的表现及研究进展[J].临床肝胆病杂志,2016,32(6):1079-1082.