64层螺旋CT对肝纤维化、肝硬化肝脾体积变化的研究

目的研究慢性肝纤维化、肝硬化肝脾体积变化与肝纤维化病理分期及肝功能分级的相关性。方法收集近期经病理及实验室、影像学检查证实的因乙肝导致的肝纤维化及肝硬化患者共41例,肝纤维化病理分期S1期7例、S2期10例、S3期4例、S4期5例、肝硬化15例,其中肝功能Child-Pugh分级A级16例,B级11例,C级14例,以及对照组15例,行上腹64层螺旋CT增强扫描。运用CT机自身携带的软件,分别对实验组及对照组肝脾体积进行测量;并计算肝脏各叶体积占总肝体积百分比、肝脾体积之比,将上述指标与肝纤维化病理分期及肝功能Child-Pugh分级进行对照。结果肝右叶、左内叶、总肝体积从正常肝脏到轻度肝纤维化（S1-2期）逐渐增大,从重度肝纤维化（S3-4期）到晚期肝硬化减小;肝左外叶、尾状叶体积随着肝纤维化程度的加重逐渐增大;脾脏体积随着肝纤维化程度的加重逐渐增大。从肝功能A级到C级,肝右叶、肝左内叶及总肝体积逐渐缩小,而左外叶和尾状叶体积及脾脏体积逐渐增大。结论慢性肝纤维化、肝硬化肝脾体积的变化有一定规律,与肝纤维化病理分期及肝功能Child-Pugh分级有明显的相关性。

Study on the Liver and Spleen Volume Changes in Chronic Hepatic Fibrosis and Cirrhosis with 64-slice CT

Objective To study the relativity of hepatic and splenic volume changes in chronic hepatic fibrosis and cirrhosis with pathologic stage of hepatic fibrosis and hepatic function. Methods To collect 41 patients with hepatic fibrosis and cirrhosis caused by the hepatitis which confirmed by pathology, laboratory and imaging studies recently, including 7 cases of S 1, 10 cases of S2, 4 cases of S3, 5 cases of S4 and 15 cases of cirrhosis by hepatic fibrosis pathologic staging, or 16 cases of A, 11 cases of B, 14 cases of C by hepatic function Child-Pugh staging. 15 healthy adults were collected as control group. All of the participants undertook abdominal 64-slice spiral enhanced CT scanning, then measured the volume of liver and spleen respectively and calculate the percentage of every lobe of the liver and volume ratio of liver and spleen. Eventually compare the above indicators with hepatic fibrosis pathologic and hepatic function Child-Pugh staging. Results From normal to mild cirrhosis（S 1-2）, right lobe, left interior lobe and the total liver volume increased gradually. From severe hepatic fibrosis to advanced cirrhosis（S3-4）, it decreased gradually： hepatic left lateral lobe, caudate lobe and spleen volume increased gradually along as cirrhosis digree; From Child-Pugh A to C, right lobe, left interior lobe and the total liver volume decreased, hepatic left lateral lobe and caudate lobe volume increased gradually. Conclusion The volume changes of the liver and spleen have a certain regularity￡-and have obvious relevance with liver fibrosis pathologyic staging and liver function Child-Pugh staging.