多层螺旋CT检查在肝硬化患者食管静脉曲张诊断和分级中的价值

背景：食管静脉曲张破裂出血是肝硬化门静脉高压的严重并发症之一,早期预防和诊断食管静脉曲张可减少并发症的发生。目的：探讨多层螺旋CT检查在肝硬化患者食管静脉曲张诊断和分级中的价值。方法：纳入肝硬化患者50例,在4周内分别行内镜和多层螺旋CT检查。由两位放射科医师采用盲法读片,分析多层螺旋CT检查诊断食管静脉曲张的敏感性,确定接受者操作特征曲线（ROC曲线）下面积（AUC）。分析两种检查方法的关联性和差异性。结果：以内镜检查结果为金标准,两位放射科医师以多层螺旋CT检查诊断食管静脉曲张的敏感性分别为95.1%和97.6%,AUC分别为0.913和0.717。两种检查方法的结果有关联性（P〈0.001）,无差异性。多层螺旋CT检查的依从性优于内镜检查（P〈0.001）。结论：多层螺旋CT检查对诊断肝硬化食管静脉曲张具有较高的价值,可指导临床选择预防和治疗方案,且较内镜检查更易为患者所接受。

Value of Multislice Spiral CT in Detecting and Grading of Esophageal Varices in Cirrhotic Patients

Background： Esophageal variceal bleeding is one of the serious complications of portal hypertension in cirrhotic patients. Early prevention and detection of esophageal varices is crucial in minimizing the complications. Aims： To appraise the value of muhislice spiral CT in detecting and grading of esophageal varices in cirrhotic patients. Methods： A total of 50 cirrhotic patients who underwent both endoscopy and muhislice spiral CT within a 4-week interval were prospectively evaluated. Sensitivity of multislice spiral CT in detecting esophageal varices were analyzed blindly by two radiologists. Area under the receiver operating characteristic （ROC） curve （AUC） was measured. The relevance and difference of the two examinations were analyzed. Results： Based on the resuhs of endoscopy, the sensitivity of multislice spiral CT for esophageal varices by the two radiologists was 95.1% and 97.6%, and AUC was 0.913 and 0.717, respectively. There was a strong relevance （P〈0.001） but no difference between the results of the two methods of examinations. Patient compliance of multislice spiral CT was better than that of endoscopy （P〈0.001）. Conclusions： Muhislice spiral CT is useful for the detection of esophageal varices in cirrhotic patients, which can guide the prevention and treatment of esophageal varices clinically. Multislice spiral CT is more acceptable by the patient rather than endoscopy.