CAJ | 학술논문

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,显著低于无脂肪变性者.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、肝/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.
목적 탐토CT소묘체대간장활검병리검사평개지방변성적가행성.방법 회고성분석북경대학인민의원2006-2009년실시적215례원위간이식환자적림상자료.대간장활검병리표본화라선CT소묘자료진행재평개.대간장CT치、간/비CT치비치、간/강주동맥CT치비치급간/하강정맥CT치비치여병이학지방변성정도진행상관성분석.결과 215례공간활검조직표본중52례존재정도불동적지방변성,점전부병례적24.2％,지방변성정도개우2.78％～ 56.8％,평균위17.00％±13.75％.병이학학인존재지방변성간장적평균CT치、간/비CT치비치、간/강주동맥CT치비치、간/하강정맥CT치비치분별위(41.3±7.5) HU、0.89±0.16、1.02 ±0.16、1.04±0.15,현저저우무지방변성자.간장지방변성정도여간장CT치、간/비CT치비치、간/강주동맥CT치비치、간/하강정맥CT치비치균정부상관,상관계수분별위-0.881(P ＜0.01)、-0.817 (P＜ 0.05)、-0.951(P ＜0.001)、-0.948(P ＜0.001).결론 간장적CT치、간/비CT치비치、간/강주동맥CT치비치、간/하강정맥CT치비치균가이정량반응간장지방변성적엄중정도,기중이간/강주동맥CT치비치최위준학.
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,liverdescending 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.