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磁共振成像对酒精性肝硬化与病毒感染所致肝硬化的鉴别诊断

Discrimination of alcoholic from virus-induced cirrhosis on MR imaging.

作者信息

Okazaki H, Ito K, Fujita T, Koike S, Takano K, Matsunaga N

机构信息

Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.

出版信息

AJR Am J Roentgenol. 2000 Dec;175(6):1677-81. doi: 10.2214/ajr.175.6.1751677.

Abstract

OBJECTIVE

The purpose of this study was to determine whether MR features help to differentiate virus-induced cirrhosis from alcoholic cirrhosis.

MATERIALS AND METHODS

The MR examinations of 53 patients with cirrhosis (38 men and 15 women; age range, 28-73 years) caused by hepatitis B (n = 16), hepatitis C (n = 18), or alcohol abuse (n = 19) were retrospectively reviewed independently by two radiologists. The following MR features were assessed by each radiologist independently: volume indexes of the spleen and of each liver segment (based on 3-axis measurements), the nodularity of the surface, and the presence of regenerative nodules, ascites, iron or fat deposition, varices or collateral veins, the right posterior hepatic notch, and an expanded gallbladder fossa.

RESULTS

The mean values of the volume index of the caudate lobe were significantly greater (p < 0.0001) in the group with alcoholic cirrhosis than those in the group with viral cirrhosis. The frequency of visualization of the right posterior hepatic notch in the patients with alcoholic cirrhosis was significantly greater (p < 0.05) than that in the patients with viral cirrhosis. The size of regenerative nodules of the liver in the patients with cirrhosis caused by hepatitis B was significantly greater (p < 0.02) than that in the patients with alcoholic cirrhosis.

CONCLUSION

Enlargement of the caudate lobe and the presence of the right posterior hepatic notch on MR imaging are more frequent findings of alcoholic cirrhosis than of virus-induced cirrhosis.

摘要

目的

本研究的目的是确定磁共振成像(MR)特征是否有助于鉴别病毒诱导的肝硬化与酒精性肝硬化。

材料与方法

对53例肝硬化患者(38例男性和15例女性;年龄范围28 - 73岁)进行了回顾性研究,这些患者分别由乙型肝炎(n = 16)、丙型肝炎(n = 18)或酒精滥用(n = 19)引起。两名放射科医生独立回顾了这些患者的MR检查结果。每位放射科医生独立评估以下MR特征:脾脏和每个肝段的体积指数(基于三维测量)、表面结节性、再生结节的存在、腹水、铁或脂肪沉积、静脉曲张或侧支静脉、肝右后切迹以及胆囊窝扩大情况。

结果

酒精性肝硬化组尾状叶体积指数的平均值显著高于病毒诱导的肝硬化组(p < 0.0001)。酒精性肝硬化患者肝右后切迹的显示频率显著高于病毒诱导的肝硬化患者(p < 0.05)。乙型肝炎引起的肝硬化患者肝脏再生结节的大小显著大于酒精性肝硬化患者(p < 0.02)。

结论

在MR成像上,尾状叶增大和肝右后切迹的出现,酒精性肝硬化比病毒诱导的肝硬化更为常见。

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