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目的探讨采用螺旋CT增强延迟扫描对肝细胞外间隙(f ECS)大小进行定量评估的可行性。方法选取因接受尿路造影检查的32名既往无肝脏疾病史的成年人(对照组)以及32例经病理证实的肝纤维化患者(病例组),注射对比剂10分钟后进行延迟扫描,测量其f ECS,并与病理分级对照(分级标准参照慢性乙型肝炎防治指南2010版)。结果对照组f ECS为(29.8±5.6)%,病例组f ECS为(36.9±5.9)%,两者之间的差异具有统计学意义(P<0.0001);根据ROC曲线下面积为0.961时,f ECS与病理分级结果相一致。以f ECS等于30.8%作为肝纤维化的切割点,灵敏度为100.0%,特异度为75.0%。结论螺旋CT增强延迟扫描能够对f ECS的大小进行定量评估,f ECS有可能能够预示肝纤维化的严重程度。
Objective To explore the feasibility of quantitatively evaluating the size of hepatocyte extracellular gap (f ECS) by enhanced spiral CT scan. Methods Thirty-two adults with no previous history of liver disease (control group) and 32 patients with pathologically confirmed liver fibrosis (case group) undergoing urography were enrolled in this study. Ten minutes after the injection of contrast agent, delayed scanning was performed to measure Its f ECS, and pathological grading (grading standards reference chronic hepatitis B Guide 2010 Edition). Results The f ECS was (29.8 ± 5.6)% in the control group and (36.9 ± 5.9)% in the case group, the difference was statistically significant (P <0.0001). According to the area under the ROC curve was 0.961, f ECS consistent with the pathological grading results. With f ECS equal to 30.8% as the cut point for hepatic fibrosis, the sensitivity was 100.0% and the specificity was 75.0%. Conclusion Spiral CT enhanced delayed scanning can quantitatively evaluate the size of f ECS, f ECS may be able to predict the severity of liver fibrosis.