【摘要】 目的探讨肝硬化引起的肺周围血管扩张的CT征象在不同Child-Pugh分级和不同肝硬化病程间的差异性。方法回顾性收集白银市第二人民医院2012年4月—2016年6月间120例肝硬化病人作为研究对象,男69例,女51例,年龄34~85岁,平均(56.42±11.32)岁。将病人按Child-Pugh分级(Child A、Child B、Child C)和肝硬化病程时间(≤3年和>3年)分别分组。120例病人均进行胸部螺旋CT平扫,观察病人以下4种CT征象:(1)肺血管纹理增粗达胸膜面;(2)双肺小结节影;(3)双肺底层面网格状影;(4)右肺底层面平均密度。采用t检验、单因素方差分析及χ2检验比较组间的统计学差异。结果按Child分级的3组间比较,肺血管纹理增粗达胸膜面数量、双肺小结节的数量、双肺底层面网格状影的出现以及右肺底层面平均密度间差异均有统计学意义(均P<0.05)。其中,Child C组各项数据均高于Child A组、Child B组,Child B组高于Child A组(均P<0.05)。3组间肺血管纹理增粗达胸膜面和双肺小结节影的定性分析比较差异均无统计学意义(均P>0.05)。按病程时间分组的2组间比较,>3年组的上述4项CT征象数值均高于≤3年组(均P<0.05)。结论肝硬化引起的肺周围血管扩张的CT征象在不同Child分级和肝硬化病程时间组之间存在差异,观察这些征象有助于提高临床诊疗。更多还原

【Abstract】 Objective To investigate CT appearances of the peripheral pulmonary vasodilatation under varied Child-Pugh scores and durations of liver cirrhosis. Methods 120 patients with liver cirrhosis were retrospectively collected from the Baiyin Second People’s Hospital from April 2012 to June 2016. There were 69 males and 51 females, and the age was 56.42±11.32 years old(range 34-85 years). Patients were divided according to Child-Pugh grades(Child A, Child B and Child C) and duration of liver cirrhosis(≤3 years, and >3 years), respectively. All the 120 patients underwent spiral CT scan of chest and the observation of CT images was focused on the following 4 signs:(1) the thickened pulmonary vascular markings adhered to the pleural surface;(2) bilateral pulmonary nodules;(3) reticular shadow at both lung bottom;(4) the average density on the CT slice of right lung bottom. Differences among groups were compared using the t test, one-way ANOVO analysis, and χ2 test. Results Among the three groups based on Child-Pugh grade, the numbers of sign 1-4 were all statistically significant(all P<0.05). The numbers of sign 1-4 were significantly higher in the Child C group than in the Child A and Child B groups, and the numbers of the sign 1-4 was significantly higher in Child B group than in the Child A group(all P <0.05). However, qualitative analysis showed no significant differences in the incidence of the signs 1 and 2 among the three groups(all P>0.05). The four CT signs were more often observed in the duration of liver cirrhosis > 3 years group than in the group ≤ 3 years group(all P <0.05). Conclusion The CT signs of peripheral pulmonary vasodilatation caused by cirrhosis were different among the different Child-Pugh grades and durations of cirrhosis. The observation of the CT signs can prompt clinical diagnosis and treatment.更多还原