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肝硬化CT分组与并发症之间的关系。

Relationship between CT grouping and complications of liver cirrhosis.

作者信息

Zhang Min-Guang, Huang Xue-Jing, Zhu Qiong, Geng Jian, Zhang An-Jun

机构信息

Department of Radiology, Shanghai Hospital of Traditional Chinese Medicine, Shanghai 200071, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2006 May;5(2):219-23.

Abstract

BACKGROUND

Imaging examination is important for hepatic cirrhosis. But the relationship between magnetic resonance (MR), computed tomography (CT) or ultrasound findings and pathological groups, degree, or reserve function of the cirrhotic liver is not clear. In this study, we investigated the relationship between the CT groupings of liver cirrhosis and its complications and clinical conditions.

METHODS

The CT findings in 357 patients with liver cirrhosis were grouped. The complications were analyzed, included splenomegaly, varicose collateral veins, ascites, pleurorrhea, primary liver carcinoma, gallbladder stone, etc. Blood routine (BRt), and serum usea nitrogen (SUN), creatinine and uric acid were measured and hypersplenia and liver-kidney syndrome were estimated.

RESULTS

Three hundred and fifty-seven patients with cirrhosis were divided into homogeneous group (87 patients, 24.4%), segmental group (41, 11.5%), and nodal group (229, 64.2%). The grade of spleen enlargement in the segmental and the nodal groups was significantly greater than that in the homogeneous group (P<0.01 and P<0.001). The patients with varices were shown in a descending order in the segmental group (70.7%), the nodal group (17.0%) and the homogeneous group (2.3%), respectively. Significant difference was observed among the 3 groups (P<0.001). Ascites was seen in 182 patients (79.5%) of the nodal group, in 11 patients (26.8%) of the segmental group and in 9 patients (10.3%) of the homogeneous group (P<0.001). Sixty-eight patients (29.7%) in the nodal group had primary liver carcinoma and 1 (2.4%) in the segmental group and 5 (5.8%) in the homogeneous group (P<0.001). The number of patients with decreased concentration of hematoglobin in the nodal group was more than that in the homogeneous group (P<0.001). The mean values of hematoglobin and platelet in the nodal group and the segmental group were significantly lower than those in the homogeneous group (P<0.05). The number of patients with increased concentration of SUN in the nodal group and the segmental group was more than that in the homogeneous group (P<0.005). The concentration of SUN in the nodal group was significantly higher than that in the homogeneous group (P<0.002).

CONCLUSION

There is a close relationship between the grouping of liver cirrhosis by CT findings and complications caused by the cirrhosis. The grouping is significant for estimating clinical conditions.

摘要

背景

影像学检查对肝硬化很重要。但磁共振成像(MR)、计算机断层扫描(CT)或超声检查结果与肝硬化肝脏的病理分组、程度或储备功能之间的关系尚不清楚。在本研究中,我们调查了肝硬化的CT分组与其并发症及临床情况之间的关系。

方法

对357例肝硬化患者的CT检查结果进行分组。分析并发症,包括脾肿大、侧支静脉曲张、腹水、胸腔积液、原发性肝癌、胆结石等。检测血常规(BRt)、血清尿素氮(SUN)、肌酐和尿酸,并评估脾功能亢进和肝肾综合征。

结果

357例肝硬化患者分为均匀组(87例,24.4%)、节段组(41例,11.5%)和结节组(229例,64.2%)。节段组和结节组的脾肿大分级明显高于均匀组(P<0.01和P<0.001)。静脉曲张患者在节段组(70.7%)、结节组(17.0%)和均匀组(2.3%)中的比例呈下降趋势。三组间差异有统计学意义(P<0.001)。结节组182例患者(79.5%)出现腹水,节段组11例患者(26.8%)出现腹水,均匀组9例患者(10.3%)出现腹水(P<0.001)。结节组68例患者(29.7%)患有原发性肝癌,节段组1例患者(2.4%)患有原发性肝癌,均匀组5例患者(5.8%)患有原发性肝癌(P<0.001)。结节组血红蛋白浓度降低的患者数量多于均匀组(P<0.001)。结节组和节段组的血红蛋白和血小板平均值明显低于均匀组(P<0.05)。结节组和节段组SUN浓度升高的患者数量多于均匀组(P<0.005)。结节组的SUN浓度明显高于均匀组(P<0.002)。

结论

CT检查结果对肝硬化的分组与肝硬化引起的并发症之间存在密切关系。该分组对评估临床情况具有重要意义。

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