Ito K, Mitchell D G, Hann H W, Outwater E K, Kim Y, Fujita T, Okazaki H, Honjo K, Matsunaga N
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Radiology. 1998 Jun;207(3):729-35. doi: 10.1148/radiology.207.3.9609897.
To determine which magnetic resonance (MR) imaging findings of cirrhosis change as disease severity progresses.
Seventy-six abdominal MR imaging studies in 38 patients (two per patient) with Child-Pugh grade A cirrhosis were retrospectively reviewed. All patients were followed up clinically and with MR imaging for 12 months or longer. MR images were used to determine volume indexes of the spleen and of each liver segment, as well as changes in hepatic contour, iron or fat deposition, and presence of varices and collateral vessels.
During follow-up in patients with progressive cirrhosis (n = 13), the volume indexes of the anterior, posterior, and medial segments of the liver decreased significantly (P = .011, .013, .002, respectively), and the number of varices and collateral vessels increased significantly (P = .018). In patients with stable cirrhosis (n = 25), the volume indexes of the spleen, caudate lobe, and lateral segment increased significantly (P = .032, .018, .003, respectively). The atrophic index was significantly greater in progressive cirrhosis than in stable cirrhosis (P = .009).
Progressive atrophy of the right hepatic lobe and the medial segment correlated with progression of clinical severity of cirrhosis, whereas increasing size of the caudate lobe and the lateral segment correlated with stability.
确定随着肝硬化疾病严重程度进展,哪些磁共振(MR)成像表现会发生变化。
回顾性分析38例Child-Pugh A级肝硬化患者(每位患者行两次检查)的76次腹部MR成像研究。所有患者均接受临床及MR成像随访12个月或更长时间。利用MR图像确定脾脏及各肝段的体积指数,以及肝脏轮廓、铁或脂肪沉积、静脉曲张和侧支血管的变化。
在肝硬化进展患者(n = 13)的随访期间,肝脏前、后、内侧段的体积指数显著降低(分别为P = .011、.013、.002),静脉曲张和侧支血管数量显著增加(P = .018)。在肝硬化稳定患者(n = 25)中,脾脏、尾状叶和外侧段的体积指数显著增加(分别为P = .032、.018、.003)。进展期肝硬化的萎缩指数显著高于稳定期肝硬化(P = .009)。
右肝叶和内侧段的进行性萎缩与肝硬化临床严重程度的进展相关,而尾状叶和外侧段的增大与病情稳定相关。