Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Clin Radiol. 2023 Dec;78(12):919-927. doi: 10.1016/j.crad.2023.07.022. Epub 2023 Aug 15.
To determine risk factors for portal venous system thrombosis (PVST) after partial splenic artery embolisation (PSAE) in cirrhotic patients with hypersplenism.
Between March 2014 and February 2022, 428 cirrhotic patients with hypersplenism underwent partial splenic artery embolisation and from these patients 208 were enrolled and 220 were excluded. Medical records of enrolled patients were collected. Computed tomography (CT) images were reviewed by two blinded, independent radiologists. Statistical analyses were performed by using SPSS.
Progressive PVST was observed in 18.75% (39/208) of cirrhotic patients after PSAE. No significant differences in peripheral blood counts, liver function biomarkers, and renal function were observed between the patients with progressive PVST and the patients without progressive PVST. The imaging data showed significant differences in PVST, the diameters of the portal, splenic, and superior mesenteric veins between the progressive PVST group and non-progressive PVST group. Univariate and multivariate analysis demonstrated portal vein thrombosis, spleen infarction percentage, and the diameter of the splenic vein were independent risk factors for progressive PVST. Seventeen of 173 (9.83%) patients showed new PVST; the growth of PVST was observed in 62.86% (22/35) of the patients with pre-existing PVST. Spleen infarction percentage and the diameter of the splenic vein were independent risk factors for new PVST after PSAE.
The present study demonstrated portal vein thrombosis, spleen infarction percentage, and the diameter of the splenic vein were independent risk factors for PVST after PSAE in cirrhotic patients with hypersplenism.
确定肝硬化脾功能亢进患者行部分性脾动脉栓塞术（PSAE）后发生门静脉系统血栓形成（PVST）的危险因素。
2014 年 3 月至 2022 年 2 月，428 例肝硬化脾功能亢进患者接受了部分性脾动脉栓塞术，其中 208 例患者被纳入研究，220 例患者被排除。收集纳入患者的病历资料。由 2 名盲法、独立的放射科医生对 CT 图像进行评估。采用 SPSS 进行统计学分析。
PSAE 后，18.75%（39/208）的肝硬化患者出现进展性 PVST。进展性 PVST 组与无进展性 PVST 组患者的外周血计数、肝功能标志物和肾功能无显著差异。影像学资料显示，PVST、门静脉、脾静脉和肠系膜上静脉的直径在进展性 PVST 组和非进展性 PVST 组之间存在显著差异。单因素和多因素分析表明，门静脉血栓形成、脾梗死百分比和脾静脉直径是进展性 PVST 的独立危险因素。173 例患者中有 17 例（9.83%）出现新的 PVST；35 例存在预先存在的 PVST 的患者中有 22 例（62.86%）观察到 PVST 增长。脾梗死百分比和脾静脉直径是 PSAE 后新发生 PVST 的独立危险因素。
本研究表明，门静脉血栓形成、脾梗死百分比和脾静脉直径是肝硬化脾功能亢进患者 PSAE 后发生 PVST 的独立危险因素。
