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目的探讨螺旋CT三期扫描对肝纤维化的诊断价值。方法对66例经肝穿刺活检病理证实的慢性乙型肝炎肝纤维化患者组和42例正常对照组进行螺旋CT三期增强扫描。根据纤维化程度分期进行影像资料和相关指标的统计分析。结果肝左叶增大,肝表面形态及肝实质密度的改变,脾脏增大,门静脉增宽和侧枝循环的建立等影像学改变,随着肝纤维化严重程度的加重而有统计学差异。本研究显示57例肝纤维化患者螺旋CT三期扫描诊断肝纤维化52例,敏感性91.2%,特异性77.8%。各期肝纤维化分期准确28例,准确率49.1%;准确判断轻度纤维化(S1、S2)或重度纤维化(S3、S4)44例,准确率77.2%,诊断早期肝硬化16例,准确率84.2%。结论螺旋CT三期扫描能判断肝纤维化的程度,而且是动态观察肝纤维化的病程演进和临床随访的有效手段。
Objective To investigate the value of three-phase spiral CT in the diagnosis of liver fibrosis. Methods Sixty-six patients with chronic hepatitis B and liver fibrosis confirmed by biopsy of liver biopsy and 42 normal controls were examined by three-phase spiral CT. According to the degree of fibrosis stages of imaging data and related indicators of statistical analysis. Results Liver left lobe enlargement, changes in liver surface morphology and liver parenchyma, splenomegaly, portal vein widening and the establishment of collateral circulation and other imaging changes, with the severity of liver fibrosis and have a statistically significant difference. This study showed that 57 cases of liver fibrosis spiral CT three-phase diagnosis of liver fibrosis in 52 cases, the sensitivity of 91.2%, a specificity of 77.8%. Accurately diagnosed 44 cases of mild fibrosis (S1, S2) or severe fibrosis (S3, S4), with an accuracy rate of 77.2%, 16 cases of early diagnosis of liver cirrhosis, Accuracy 84.2%. Conclusion Three-phase spiral CT can determine the degree of liver fibrosis, and it is an effective means to dynamically observe the course of liver fibrosis and clinical follow-up.