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为探讨经脾门静脉核素显像、胃镜及 B超检查在肝硬化门脉高压诊断中的价值及其相关性 ,采用99m 锝 -植酸钠 (99m Tc- Phytate)经脾细针穿刺给药法对 5 8例肝病与非肝病患者进行了经脾门静脉单光子发射计算机断层 (SPECT)显像 ,以观察及门脉循环情况 ,计算门体分流指数 (PSSI) ,并与胃镜、B超进行比较。结果显示 ,经脾门静脉核素显像可将肝硬化门脉高压分为四型 ,即无分流型、有分流型 (包括肝内、外分流 )、有侧支循环型、完全肝外分流型。 PSSI值非肝病对照组为 0 .192± 0 .0 6 8,慢性肝病组为 0 .2 46± 0 .0 5 7,肝硬化门脉高压组为0 .5 41± 0 .0 82。按肝硬化 Child A、B、C分级 ,三组分别为 0 .384± 0 .0 5 2、0 .5 2 3± 0 .0 72、0 .6 80± 0 .0 81。若以 PSSI>0 .36为判别阈 ,肝硬化组总阳性率为 91.7% ,其诊断价值明显优于 B超及胃镜。提示经脾门静脉核素显像既能显示脾门静脉形态及侧支循环 ,又能测定 PSSI,有助于肝硬化的早期诊断、治疗选择及预后判断。
In order to investigate the value of splenic portal vein imaging, gastroscopy and B-ultrasound in diagnosis of portal hypertension of liver cirrhosis, 99m Tc-Phytate was administered via splenic fine needle aspiration Methods Fifty-eight patients with liver disease and non-liver disease underwent spleno-portal single photon emission computed tomography (SPECT) imaging. The portosystemic shunt index (PSSI) was calculated and compared with gastroscopy and B ultrasound Compare The results showed that the splenic portal vein radionuclide imaging can be divided into four types of portal hypertension cirrhosis, that is, no shunt, a shunt (including intrahepatic and extra-shunt), collateral circulation, complete extrahepatic shunt . PSSI value of non-liver disease control group was 0.192 ± 0.06 8, chronic liver disease group was 0.46 ± 0.507, liver cirrhosis portal hypertension group was 0.41 ± 0.082. According to Child A, B and C of cirrhosis, the three groups were 0 .384 ± 0 .0 5 2,0 .5 2 3 ± 0 .0 72,0. 6 80 ± 0 .0 81 respectively. If the PSSI> 0.36 for the discrimination threshold, the total positive rate of liver cirrhosis was 91.7%, its diagnostic value was significantly better than B-mode and gastroscopy. Prompt splenic portal vein radionuclide imaging can show both portal vein morphology and collateral circulation, but also the determination of PSSI, contribute to the early diagnosis of cirrhosis, treatment options and prognosis.