关键词: 肝硬化, 多层螺旋CT, 脾功能亢进

Abstract: Objective To investigate the variations in blood flow status and changes in the internal diameter of hepatic and splenic vessels in patients with different degrees of hypersplenism. Methods A total of 36 patients diagnosed with liver cirrhosis and hypersplenism were enrolled between June 2018 and September 2022. Additionally, 40 healthy individuals who underwent examinations at our hospital during the same period were selected as the control group. Clinical data, imaging features of the liver and spleen, as well as liver perfusion parameters were compared between patients with hypersplenism and the healthy control group. Results The comparative analysis of clinical data revealed that patients diagnosed with hypersplenism exhibited significantly elevated levels of ALT, AST and GGT, with values of 87.6(34.3,378.7) U/L, 75.6(39.3,361.2) U/L and 65.7(31.3,83.6) U/L, respectively. These levels were notably higher compared to the healthy control group, which had values of 16.2(12.6,25.1) U/L,18.0(12.0,24.8) U/L and 16.3(11.6,24.0) U/L(P<0.05). Upon evaluation of imaging parameters,, it was discovered that the diameter of the splenic artery, splenic vein, portal vein, and spleen volume in patients with hypersplenism were significantly elevated compared to those of the healthy control group. Specifically, they measured approximately (7.2±1.3) mm, (13.5±2.5) mm, (16.9±2.4) mm and (1842±859.4) cm³, respectively, while the healthy control group were (5.6±0.8) mm, (10.0±1.6) mm, (14.3±1.8) mm and (398.5±149.8) cm³(P<0.05). Additionally, the measurements of splenic artery, splenic vein, portal vein and spleen in the group with moderate hypersplenism were (8.0±1.2) mm, (14.9±1.4) mm, (17.8±2.0) mm and (2361.8±894.0) cm³, respectively. In contrast, the severe hypersplenism group displayed measurements of (7.0±0.8) mm, (14.1±2.5) mm, (17.9±2.2) mm and (1994.4±783.7) cm³, which were significantly higher than those observed in the mild hypersplenism group [(6.4±1.0) mm, (11.9±1.9) mm, (15.9±1.8) mm and (1253.4±582.6) cm³(P<0.05)]. In terms of liver perfusion parameters, the PVP and TLP parameters for the caudate lobe, left lateral lobe, left medial lobe, right anterior lobe and right posterior lobe in hypersplenism group were (46.3±15.5) ml/min and (54.9±21.0) ml/min, (40.7±14.5) ml/min and (49.6±15.1) ml/min, (37.6±13.9) ml/min and (49.7±13.2) ml/min, (41.8±13.6) ml/min and (47.5±15.3) ml/min, (44.7±14.5) ml/min and (56.3±10.0) ml/min. These values were significantly lower when compared to the healthy control group [(80.4±52.7) ml/min and (91.6±56.8) ml/min, (87.8±39.4) ml/min and (98.6±51.3) ml/min, (78.0±46.5) ml/min and (87.7±48.4) ml/min, (79.2±51.1) ml/min and (87.0±42.1) ml/min, (73.1±39.3) ml/min and (85.0±37.1) ml/min(P<0.05) ]. The HPI parameters in the hypersplenism group were (18.5±12.7) %, (20.6±12.0) %, (23.6±14.8) %, (13.8±11.5) % and (20.6±7.5) %, which were significantly higher than those in the healthy control group [(12.4±6.8) %, (14.2±8.2) %, (11.7±9.0) %, (12.2±9.6) % and (12.9±7.4) %]. Conclusion Patients with hypersplenism exhibited dilated splenic, with more pronounced dilation observed in those with moderate and severe hypersplenism. Additionally, hepatic blood perfusion was reduced in patients with hypersplenism.

Key words: Liver cirrhosis, Multi-layer spiral CT, Hypersplenism