MDCT对肝硬化患者胃静脉曲张的诊断价值

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文章摘要

王爱敏，潘克华，曹国全，林洁.MDCT对肝硬化患者胃静脉曲张的诊断价值[J].放射学实践,2014,(07):805-807

MDCT对肝硬化患者胃静脉曲张的诊断价值

Value of multi detector CT in the diagnosis of gastric varices in patients with cirrhosis

DOI：10.13609/j.cnki.1000 0313.2014.07.018

中文关键词: 胃静脉曲张肝硬化体层摄影术，X线计算机

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作者	单位
王爱敏，潘克华，曹国全，林洁	温州医科大学附属第一医院放射科

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【摘要】目的：探讨多排螺旋CT（MDCT）对肝硬化门脉高压患者胃静脉曲张（GVs）的诊断价值。方法：回顾性分析96例肝硬化患者上腹部MDCT增强图像，判断GVs的有无、大小，并将结果与其胃镜结果作对照研究。结果：胃镜结果显示96例患者中24例无静脉曲张，32例仅有食管静脉曲张，16例仅有GVs，24例同时伴有食管胃静脉曲张。MDCT正确诊断了其中35例，5例为假阴性。在无GVs的56例中，MDCT正确诊断其中48例，8例为假阳性。MDCT诊断GVs的敏感度、特异度、符合率、阳性及阴性预测值分别为87.5%、85.7%、86.4%、81.4%、90.6%。在40例GVs病例中，大静脉曲张24例，小静脉曲张16例。MDCT诊断大、小GVs的符合率分别为83.3%、81.3%。结论：MDCT可较准确显示GVs的有无、大小，对临床治疗方案的选择、预后的评估有重要价值。

【Abstract】Objective:To assess the diagnostic value of multidetector CT （MDCT） in detecting gastric varices （GVs） in cirrhotic patients with portal hypertension.Methods:A total of 96 consecutive cirrhotic patients underwent abdonminal enhanced MDCT,the CT findings were analyzed retrospectively.To evaluate the existence and size of GVs displayed on CT,which were correlated with the results of endoscopy.Results:According to the results of endoscopy,among the 96 patients,24 patients didn't have GVs,32 patients had esophageal varices only,16 patients had GVs only,24 patients had both esophageal and GVs.Correct diagnosis was obtained by MDCT (n=35),with false negative (n=5).Of the 56 cases with no GVs,correct diagnosis was obtained in 48 cases,with 8 cases as false positive.Taking endoscopy as the gold standard,the sensitivity,specificity,accuracy,positive and negative predictive value for detecting GVs were 87.5%,85.7%,86.4%,81.4%,90.6% respectively.Of the 40 patients with GVs,there were large GVs (24 patients),and small GVs (16 patients),the accuracy for the diagnosis of large and small GVs was 83.3% and 81.2% respectively.Conclusion:MDCT is effective in the diagnosis of the existence and size of GVs,which plays an important role in the clinical treatment planning and prognosis predicting.

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