CAJ | 학술논문

目的：探讨肝硬化性脾动脉瘤(SAA)的 CT 表现及其与肝硬化病程关系。方法回顾性分析2024例肝硬化不合并肝癌患者,发现61例合并 SAA,对其临床及 CT 资料进行分析。结果肝硬化患者合并 SAA 的总发生率3.0%(女13.6%,男1.5%,门脉高压者9.3%,脾大者10.2%)。CT 显示 SAA 常多发,主瘤体多位于脾动脉主干中远段、直径多>1.0 cm、多呈圆形,小 SAA 多位于脾动脉分支、直径多≤1.0 cm、多呈梭形(P =0.000)。随着肝硬化病程的延长,主瘤体位于脾动脉近端增多、直径增大,分支瘤体数量增多,且瘤壁钙化、瘤周血肿、瘤腔内附壁血栓、巨脾/脾梗死和曲张静脉团的发生率增高(P =0.000)。结论女性、伴有门脉高压和脾大的肝硬化患者 SAA 发生率高。CT 能够清晰显示 SAA 的好发部位、数量、大小、形态、瘤体合并征象及门脉高压相关征象,SAA 的 CT 表现与肝硬化病程密切相关,为治疗方式选择提供指导。
목적：탐토간경화성비동맥류(SAA)적 CT 표현급기여간경화병정관계。방법회고성분석2024례간경화불합병간암환자,발현61례합병 SAA,대기림상급 CT 자료진행분석。결과간경화환자합병 SAA 적총발생솔3.0%(녀13.6%,남1.5%,문맥고압자9.3%,비대자10.2%)。CT 현시 SAA 상다발,주류체다위우비동맥주간중원단、직경다>1.0 cm、다정원형,소 SAA 다위우비동맥분지、직경다≤1.0 cm、다정사형(P =0.000)。수착간경화병정적연장,주류체위우비동맥근단증다、직경증대,분지류체수량증다,차류벽개화、류주혈종、류강내부벽혈전、거비/비경사화곡장정맥단적발생솔증고(P =0.000)。결론녀성、반유문맥고압화비대적간경화환자 SAA 발생솔고。CT 능구청석현시 SAA 적호발부위、수량、대소、형태、류체합병정상급문맥고압상관정상,SAA 적 CT 표현여간경화병정밀절상관,위치료방식선택제공지도。
Objective To explore the CT manifestations of splenic artery aneurysm (SAA)in patients with liver cirrhosis,and its relationship with degree of cirrhosis.Methods SAA in 61 patients were confirmed from total 2 024 patients with liver cirrhosis but without hepatoma,and the clinic and CT data were retrospectively analyzed.Results SAA incidence rate of 3.0% (13.6% of women,1.5% of men,9.3% of portal hypertension and 10.2% of hypersplenotrophy)was observed in patients with liver cirrhosis. Multiple SAAs usually were showed with large round lesions (>1.0 cm)in the middle and distal segment of splenic artery and small fusiform ones (≤1.0 cm)in the branches of splenic artery (P =0.000).With the gradual deterioration of cirrhosis produce,the number and size of large aneurysms in proximal segment of splenic artery and number of small ones were increased with more inci-dence rates of calcification of aneurysm wall,haematoma of peri-aneurysm,mural thrombosis in SAA,megalosplenia/infarction of spleen and phlebeurysma (P =0.000).Conclusion Higher incidence rate of SAA in female patients with liver cirrhosis,portal hy-pertension and hypersplenotrophy is observed.CT can show well the location,number,size,shape and other features of SAA and portal hypertension,CT findings are correlated with the degree of cirrhosis,which may help for the treatment.