多层螺旋CT门静脉成像对肝硬化分级及食管静脉曲张出血分析

目的分析肝硬化门脉高压患者门静脉系统血管径线变化及与食管静脉曲张出血的关系，探讨多层螺旋CT门静脉成像（MSCTP）在肝硬化分级及食管静脉曲张出血中的临床价值。方法使用多层螺旋CT对200例对照组及63例肝硬化患者（出血组31例、非出血组32例）的门静脉、脾静脉和肠系膜上静脉直径及门静脉长度的测定，比较门静脉诸血管参数在对照组与肝硬化组、不同肝硬化分级间及食管静脉曲张出血间有无差异。结果肝硬化组门静脉上述参数均大于对照组（P〈0．01），但在肝硬化分级中除肠系膜上静脉Child—Pugh C级较A与B级增宽外，其他参数差异均无统计学意义（P〉0．05）。出血组的门静脉参数较非出血组除门静脉长度外均有增大（P〈0．05）。结论MSCTP能够反映肝硬化门静脉高压的程度，并对预测食管静脉出血有重要临床意义。

Anlysis of cirrhotic grade and esophageal variceal bleeding with muti-slice CT portography

Objective To analyze the diameter and length of portal system in cirrhotics with portal hypertension and its correlation with esophageal variceal bleeding(EVB) and evaluate the clinic value in cirrhotic grade and esphgeal variceal bleeding with multi-slice CT(MSCT) portography. Methods All 63 patients with cirrhosis and 200 cases in control group underwent MSCT and the diameter of the portal trunk, spleen vein, superior mesenteric vein and the length of portal trunk were measured, the blood vessel parameters of portal system were compared with those of control group and cirrhotic group,different cirrhotic classes and were compared with EVB and no EVB. Results The above parameters of portal system in cirrhotic group were all higher than those of control group(P<0.01),the diameter of super mesenteric vein in Child-Pugh C grade was larger than that in Child-Pugh A and B grade, the rest parameters were no statistic significance in different cirrhotic grades(P>0.05). The portal diameter of EVB group was larger than that of no EVB group(P <0.05). Conclusion MSCTP can reflect the extent of cirrhotic portal hypertension and is of great clinic value in the estimation of EVB.