肝脏 ›› 2024, Vol. 29 ›› Issue (9): 1096-1099.

• 肝纤维化及肝硬化 • 上一篇    下一篇

乙型肝炎肝硬化门静脉高压症患者食管静脉曲张侧支循环的CT灌注成像研究

丹巴玉珍, 王婉婷   

  1. 610000 四川 成都市第三人民医院放射科(丹巴玉珍);西南交通大学附属医院 放射科(王婉婷)
  • 收稿日期:2023-08-10 出版日期:2024-09-30 发布日期:2024-11-13

CT perfusion imaging study of esophageal variceal collateral circulation in patients with hepatitis B cirrhosis portal hypertension

DANBA Yu-zhen1, WANG Wan-ting2   

  1. 1. Department of Radiology, Chengdu Third People’s Hospital, Sichuan 610000, China;
    2. Department of Radiology, Affiliated Hospital of Southwest Jiaotong University, Sichuan 610000, China
  • Received:2023-08-10 Online:2024-09-30 Published:2024-11-13

摘要: 目的 探讨乙型肝炎肝硬化门静脉高压症患者食管静脉曲张侧支循环的CT灌注成像。方法 2021年8月—2023年7月我院收治的乙型肝炎肝硬化门静脉高压症食管静脉曲张患者105例作为发生组,再选择同期未见食管静脉曲张患者60例作为对照组。比较两组CT灌注参数,采用ROC曲线分析CT灌注成像预测乙型肝炎肝硬化门静脉高压症患者并发食管静脉曲张的价值。结果 发生组平均造影剂通过时间、造影剂峰值时间、血管渗透性分别为(13.8±3.5)s、(19.9±5.4)s、(40.8±11.3)mL/(100 g·min),均高于对照组[(10.2±2.4)s、(17.1±3.1)s、(31.7±10.2)mL/(100 g·min)],发生组的血流量为(16.5±3.6)mL/(100 g·min),低于对照组[(22.8±5.3)mL/(100 g·min),P<0.05];ROC曲线分析结果显示,CT灌注成像中平均造影剂通过时间、造影剂峰值时间、血管渗透性、血流量变化在预测乙型肝炎肝硬化门静脉高压症患者并发食管静脉曲张中具有极高的价值。结论 CT灌注成像中平均造影剂通过时间、造影剂峰值时间、血管渗透性、血流量变化可作为预测乙型肝炎肝硬化门静脉高压症患者并发食管静脉曲张的指标,具有极高的评估价值。

关键词: 乙型肝炎肝硬化, 门静脉高压症, 食管静脉曲张, 侧支循环, CT灌注成像

Abstract: Objective To investigate CT perfusion imaging of the lateral branch circulation of esophageal varices in patients with portal hypertension in hepatitis B cirrhosis. Methods Between August 2021 and July 2023, 105 patients with hepatitis B cirrhosis portal hypertension with esophageal varices were admitted to our hospital as the occurrence group, and 60 patients with no esophageal varices in the same period were selected as the control group. CT perfusion imaging was performed in both groups, and their parameters were compared between the two groups. ROC curve was used to analyze the value of CT perfusion mean contrast passage time, peak contrast time, vascular permeability, and blood flow changes in predicting oesophageal varices in patients with portal hypertension in hepatitis B cirrhosis. Results The mean contrast passage time, peak contrast time, and vascular permeability of the occurrence group were (13.8±3.5) s, (19.9±5.4) s, and (40.8±11.3) mL/(100 g·min), respectively, which were higher than those of the control group [(10.2±2.4) s, (17.1±3.1) s, and (31.7±10.2) mL/(100 g·min)], the blood flow in the occurrence group was (16.5±3.6) mL/(100 g·min), which was lower than that in the control group [(22.8±5.3) mL/(100 g·min), P<0.05]; The results of ROC curve analysis showed that CT perfusion mean contrast passage time, peak contrast time, vascular permeability, and blood flow changes were of great value in predicting esophageal varices in patients with hepatitis B cirrhotic portal hypertension complicated. Conclusion CT perfusion mean contrast passage time, peak contrast time, vascular permeability, and blood flow changes can be highly evaluated as predictors of concomitant esophageal varices in patients with hepatitis B cirrhotic portal hypertension.

Key words: Hepatitis B cirrhosis, Portal hypertension, Esophageal varices, Collateral circulation, CT perfusion imaging