连续CT检查对病毒性慢性肝病的诊断价值

目的:评价连续CT检查对病毒性慢性肝病的临床应用价值。方法:回顾性分析42例病毒性慢肝患者连续螺旋CT检查>2年的系列图像,测量肝(左、右叶)及脾体积,以及侧支循环的范围及程度。所有病例的CT表现与肝功能(按Child-Phgh分级)和肝组织学结果进行对照。结果:13例Child分级积分增加(积分增加组),其余积分无改变(积分不变组)。在积分增加组初次检查与末次检查相比肝体积比率明显变小(P<0.05),右叶体积比率也明显变小(P<0.01)。左叶及脾体积比率在初末次检查均无明显变化(P>0.05)。积分不变组中有6例初末次检查示侧支循环的范围及程度均有发展。结论:连续CT检查对评价病毒性慢性肝病十分有用。肝体积变小,尤其是右叶体积变小提示病情进展。

Serial CT examinations for diagnosis of chronic viral liver disease

Objective:To evaluate the usefulness of serial CT examinations in the diagnosis of chronic viral liver disease.Methods:We calculated the liver (left and right lobes) and spleen volums of 42 patients with chronic viral liver disease,who were examined serially for >2 years by using helical CT scanner.The level and scope of collateral formations were also checked.These CT findings were compared with the liver function tests by Child-Pugh score and histologic examination.Results:The Child-Pugh score got worse in 13 patients (score-increased group)and did not change in the other patients(score-static group).The liver volume ratio berween the first and last CT examinations was significantly smaller in the score-increased group than in the score-static group(P<0.05).The right lobe volume ratio was also significantly smaller in the score-increased group(P<0.01).The left lobe volume ratio and spleen volume ratio were not significantly different between the two groups (P>0.05).In six patients collateral formations progressed.Conclusion:Serial CT exarninations are useful to evaluate patients with chronic viral liver disease.When liver volume,especially for right lobe volume get smaller,it means progression of the disease.