摘要
目的探讨cT扫描替代肝脏活检病理检查评价脂肪变性的可行性。方法回顾性分析北京大学人民医院2006--2009年实施的215例原位肝移植患者的临床资料。对肝脏活检病理标本和螺旋CT扫描资料进行再评价。对肝脏CT值、肝／脾CT值比值、肝／降主动脉CT值比值及肝／下腔静脉CT值比值与病理学脂肪变性程度进行相关性分析。结果215例供肝活检组织标本中52例存在程度不同的脂肪变性，占全部病例的24．2％，脂肪变性程度介于2．78％～56．8％，平均为17．00％±13．75％。病理学确认存在脂肪变性肝脏的平均cT值、肝／脾cT值比值、肝／降主动脉CT值比值、肝／下腔静脉CT值比值分别为（41．3±7．5）HU、0．89±0．16、1．02±0．16、1．04±0．15，显著低于无脂肪变陛者。肝脏脂肪变性程度与肝脏cT值、肝／脾CT值比值、肝／降主动脉CT值比值、且干／下腔静脉CT值比值均呈负相关，相关系数分别为－0．881（P〈0．01）、－0．817（P〈0．05）、－0．951（P〈0．001）、－0．948（P〈0．001）。结论肝脏的CT值、肝／脾CT值比值、肝／降主动脉CT值比值、肝／下腔静脉CT值比值均可以定量反应肝脏脂肪变性的严重程度，其中以肝／降主动脉CT值比值最为准确。
Objective To evaluate the role of CT in quantitative assessment for hepatic steatosis. Methods We retrospectively assessed 215 liver grafts used in orthotopic liver transplantation （LT） from January 2006 to December 2009. Pathology and CT data were reviewed. The correlation between liver steatosis level and CT value of the liver were analyzed. The ratio of liver-spleen, liver-descending aorta, liver-inferior vena cava were calculated. Results There were 52 steatosis grafts diagnosed by pathologist and the steatosis level was from 2.78% to 56. 8%. The CT value of the liver, the ratio of liver-spleen, liver- descending aorta, liver-inferior vena cava was 41.3 ± 7.5 HU, 0. 89 ± 0. 16, 1.02 ± 0. 16, 1.04 ± 0. 15, respectively. There were significant linear negative correlation between the steatosis level and the CT value, the ratio of liver-spleen, liver-descending aorta and liver-inferior vena cava. The correlation index was -0.881, -0.817, -0.951 and -0.948, respectively. Conclusions The CT value of the liver, the ratio of liver-spleen, liver-descending aorta and liver-inferior vena cava could be used to quantitatively evaluate liver steatosis. The ratio of liver-descending aorta was the most sensitive index.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第3期220-222,共3页
Chinese Journal of General Surgery
基金
首都医学发展科研基金资助项目（2009-2029）
