肝脏脾脏密度改变对慢性肝纤维化早期肝硬化诊断价值.docVIP

肝脏脾脏密度改变对慢性肝纤维化早期肝硬化诊断价值 　　摘要： 目的：探讨不同程度肝纤维化肝、脾密度的变化特点及其临床应用价值。方法：对经肝穿刺病理活检确诊的肝纤维化S1期12例、S2期14例、S3期9例、S4期／早期肝硬化13例、典型肝硬化16例以及20例正常组行上腹部16层螺旋CT平扫和增强扫描，于CT平扫图像上分别测量肝脏、脾脏密度及肝／脾CT值比值，将上述参数值与病理学分期作对照研究和统计学分析。结果：随着肝纤维化、肝硬化程度的加重，肝脏各叶的密度及肝平均密度均呈先降低后增高的趋势，其中S4期／早期肝硬化组肝脏各叶及平均密度最低。各组之间脾脏密度的比较均无差异。肝／脾CT值比值先降低后增高；S4期的肝／脾CT值比值最低(1．08±0 ．07)，且与各组比较均有统计学差异。结论:肝脏密度和肝／脾CT值比值的测定对于早期肝 硬 化的诊断有一定帮助,但是其临床应用价值是有限的，不能简单的通过肝、脾密度的测量来 诊断肝纤维化或早期肝硬化。 　　关键词：肝纤维化；病理学分期；密度；16层螺旋CT 　　中图分类号： R445；R575.2 文献标识码： A 文章编号： 1008-2409(2008)03-0413-03 　　 　　The diagnostic value of hepatic and splenic density for chronic hepatic fibrosi sandearlycirrhosis/DING Ke,HUANG Zhong-kui,LONG Li-ling,et al.∥Departme nt of Radiology, The First Affiliated Hospital of Guangxi Medical University, Na nning 530021, China 　　Abstract: Objective:To investigate the feat ure of hepatic and splenic density change in chronic hepatic fibrosis, and explore its clinical application value. Methods: Plain and tri-stage enhanc e CT sc anof epigast was performed in 84 participants, including 48 patients with hepaticfibrosis which divided into S1(12/48), S2(14/48), S3(9/48) and S4(13/48) confirm e d by liver pathologic biopsy,16 patients with typical cirrhosis, and 20 healthysubjects as control group. Hepatic and splenic density were measured on image ofplain scan respectively, density ratios of liver/spleen was calculated in compa r ison with histopathologic stage. Results:The density of hepatic lobes and totalliver trended to decreased at S1-4(S4 was minimun) but increased slightly thanS 4 at typical cirrhosis.The density of spleen had no significant difference amongall groups.The density ratios of liver/spleen at S4 was minimum(1.08±0. 07) and had statistical difference with other groups. Conclusion:The measuremen t ofhepatic density and CT value ratios of liver/spleen may be helpful for the diag nosis of early cirrhosis, but its clinical application value was limited, its i mp ossible to diagnose hepatic fibrosis or early cirrho