SCTAP评价肝硬化及门静脉高压的临床价值

目的 :评价螺旋CT经动脉门静脉造影 (SCTAP)对肝硬化、门静脉高压判断的临床价值。方法 :根据临床综合诊断标准 ,比较 2 6例采用常规CT、SCTAP轴位及MIP法三维重建判断肝硬化、门静脉高压的结果。结果 :SCTAP对门静脉远侧分支的显示明显优于常规CT(P <0 .0 1)。SCTAP轴位能较好显示门静脉细小分支的异常改变 ,对肝硬化判断的敏感性为 93.3%。SCTAP MIP能直观地显示门静脉的全貌及侧支循环通路 ,对门静脉高压的判断的特异性为 94 .1%。常规CT能较全面反映门静脉高压的肝外征象 (脾大、腹水 )。结论 :SCTAP与常规CT、临床及实验室检查结合 ,有助于肝硬化、门静脉高压的准确判断。

Clinical value of spiral CT during arterial portography in the evaluating of the hepatocirrhosis and portal hypertension

Objective:To evaluate the clinical value of spiral CT during arterial portography (SCTAP) in judgment of cirrhosis and portal hypertension.Methods:Compared the results of the judging cirrhosis and portal hypertension when dealing with conventional CT, axial imaging of SCTAP and maximum intensity projection (MIP) three-dimensional reconstruction imaging of SCTAP in 26 patients, according to the clinical combined standard of diagnosis.Results:SCTAP demonstrated the distal branches of portal vein better than conventional CT(p<0.01). Axial imaging of SCTAP could preferably demonstrate abnormal changes of the fine branches of portal vein, its sensitivity of judging cirrhosis was 93.3%. Maximum intensity projection (MIP) three-dimensional reconstruction imaging of SCTAP could directly demonstrate the panorama of portal vein and the collateral circulation, its specificity of judging portal hypertension was 94.1%.Conventional CT could completely reflect the extrahepatic signs of portal hypertension (splenomegaly, ascites).Conclusion:SCTAP combining with conventional CT,clinic and laboratory examination was helpful to evaluate cirrhosis and portal hypertension accurately.