Zhou Hai-Ying, Chen Tian-Wu, Zhang Xiao-Ming, Jing Zong-Lin, Zeng Nan-Lin, Zhai Zhao-Hua
Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong, Sichuan 637000, China.
Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong, Sichuan 637000, China.
Clin Res Hepatol Gastroenterol. 2015 Jun;39(3):351-8. doi: 10.1016/j.clinre.2014.09.012. Epub 2014 Dec 6.
To determine associations of patterns of portosystemic collaterals and diameters of portal venous system in cirrhotic patients with hepatitis B on magnetic resonance (MR) imaging with Child-Pugh classification.
Eighty-eight consecutive patients with cirrhosis resulting from chronic hepatitis B graded by Child-Pugh classifications were recruited and undergone MR portography. Patterns of the collaterals (presented as no collateral, isolated esophageal varices, and esophageal varices combined with other shunts), and diameters of portal venous system including portal vein (PV), left portal vein (LPV), right portal vein (RPV), splenic vein (SV) and superior mesenteric vein (SMV) were assessed statistically to determine associations of patterns of collaterals and diameters of the portal veins with Child-Pugh classification.
From no collateral, to isolated esophageal varices, and to the varices combined with other shunts, the Child-Pugh classifications tended to increase (r=0.516, P<0.001). Diameters of PV, LPV, RPV, SV and SMV tended to increase from Child-Pugh A to B but decrease from B to C. Differences in diameter of LPV and SV were significant between Child-Pugh A-B and C (all P<0.05) while no differences in diameters of other portal veins were found (all P>0.05). For discriminating Child-Pugh A-B from C, either a cut-off LPV diameter of 8.98mm or SV diameter of 9.10mm achieved a sensitivity of 67%-70%, specificity of 51%-53%.
Patterns of portosystemic collaterals and diameters of LPV and SV tend to be associated with Child-Pugh classifications of cirrhosis.
确定乙型肝炎肝硬化患者门静脉系统侧支循环模式及直径在磁共振成像（MR）上与Child-Pugh分级的相关性。
招募88例按Child-Pugh分级的慢性乙型肝炎肝硬化患者，并进行磁共振门静脉造影。对侧支循环模式（分为无侧支循环、孤立性食管静脉曲张、食管静脉曲张合并其他分流）以及门静脉系统各血管直径，包括门静脉（PV）、左门静脉（LPV）、右门静脉（RPV）、脾静脉（SV）和肠系膜上静脉（SMV）进行统计学评估，以确定侧支循环模式及门静脉直径与Child-Pugh分级的相关性。
从无侧支循环到孤立性食管静脉曲张，再到食管静脉曲张合并其他分流，Child-Pugh分级呈上升趋势（r = 0.516，P < 0.001）。PV、LPV、RPV、SV和SMV的直径从Child-Pugh A级到B级呈上升趋势，但从B级到C级呈下降趋势。Child-Pugh A - B级与C级之间LPV和SV直径差异有统计学意义（均P < 0.05），而其他门静脉直径差异无统计学意义（均P > 0.05）。对于区分Child-Pugh A - B级与C级，LPV直径截断值为8.98mm或SV直径截断值为9.10mm时，灵敏度为67% - 70%，特异度为51% - 53%。
门静脉系统侧支循环模式以及LPV和SV直径往往与肝硬化的Child-Pugh分级相关。
