【摘要】 目的　分析肝硬化患者结肠壁增厚的CT影像特征 ,评价其与肝硬化进展程度的关系。材料与方法　 69例肝硬化中 ,3 9例为CT增强扫描 ,3 0例为平扫。分析CT像上结肠壁增厚 (>3mm)的征象、发生率、分布情况 ,并统计分析其与肝功能分级 (Child Pugh)的关系 ,10 0例正常者为对照组。结果　 44.9%肝硬化患者显示结肠壁增厚 ,与对照组 (2 2 % )比较有统计学意义。其中77.4%主要发生于右半结肠 ,2 2 .6%为全结肠受累 ,表现为环状同心型增厚或结肠袋的结节状增厚 ;66%的患者强化不明显。肝硬化结肠壁增厚在肝功能A、B、C各级中的发生率分别为 3 4 %、5 8%及 75 % ,其发生、发展与Child Pugh分级成正相关 ,主要与白蛋白水平负相关。结论　结肠壁增厚常见于失代偿期肝硬化 ,右半结肠为最好发部位 ,与肝硬化严重程度相关。白蛋白水平降低及门脉高压可能为其发生的主要原因。更多还原

【Abstract】 Objective To evaluate CT features of colonic wall thickening in patients with cirrhosis, and to study its correlation with the severity of hepatic dysfunction.Materials and Methods CT findings of colonic wall thickening (>3mm) in 69 patients with cirrhosis (study group, including 39 contrast-enhanced scans and 30 plain scans) and in 100 patients without cirrhosis (control group) were retrospectively assessed. The incidences of colonic wall thickening in two groups were calculated and statistically analyzed. A correlative study of wall thickening with the severity of hepatic dysfunction (Child-Pugh classification) was made.Results Colonic wall thickening was seen in 31 (44.9%) patients with cirrhosis and in 22 (22%) control subjects (P<0.01). Of the colonic wall edema, 77.4% (24/31) were located in right-side colons, while 22.6% were diffusely distributed over the whole colon. Wall thickening was manifested as concentric pattern or nodular thickening of the haustra, with poor contrast enhancement. The frequency of colonic wall thickening in Child-Pugh A, B and C group was 34%, 58% and 75%, respectively. Its occurrence and progress was positively correlated with the Child-Pugh classification levels, especially with the level of the serum albumin.Conclusion Colonic wall thickening is a common finding on CT scans in patients with decompensated cirrhosis. It frequently involves right-side colon and bears a relationship to the severity of hepatic dysfunction. Most probably, hypoalbuminemia and portal hypertension are its main causes.更多还原