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目的运用探讨多层螺旋CT(MSCT)图像后处理技术测量分析肝硬化合并门静脉血栓(PVT)及脾动脉瘤(SAA)的扫描数据,探讨肝硬化合并PVT和SAA的关系及危险因素。方法收集肝炎后肝硬化合并PVT和SAA患者13例(观察组),对照组为同期收治的肝炎后肝硬化合并SAA患者23例,两组均排除肝癌及其他恶性肿瘤。利用MSCT图像后处理技术回顾性分析两组患者的CT资料,分析SAA部位、数量、大小、脾动脉内径、脾静脉内径、门静脉内径、脾脏厚度及脾脏斜径;采用Logistic回归模型筛选肝硬化合并PVT和SAA的关系及危险因素。结果观察组13例中,发现动脉瘤23个,单发8例,多发5例;发生于脾动脉中段3个,脾动脉远段20个。对照组23例中,发现动脉瘤38个,单发16例,多发7例;发生于脾动脉中段7个,脾动脉远段31个。两组SAA短径、脾动脉内径、脾静脉内径、门静脉内径差异无统计学意义(P>0.05),观察组脾脏厚度高于对照组[(6.40±1.03)cm vs.(5.30±1.19)cm,P<0.01],观察组脾脏斜径高于对照组(P<0.05)。Logistic回归模型分析显示,脾脏厚度是肝硬化合并PVT和SAA的独立危险因素(OR=0.373,P<0.05)。结论 MSCT图像后处理技术下脾脏厚度值可用于肝硬化合并PVT及SAA风险预测及评估。
Objective To investigate the relationship between cirrhosis and PVT and SAA and the risk factors by using multi-slice spiral CT (MSCT) post-processing technique to measure and analyze the data of cirrhosis complicated with portal vein thrombosis (PVT) and splenic aneurysm (SAA). Methods Thirteen patients with posthepatitic cirrhosis complicated with PVT and SAA were enrolled in this study. The control group consisted of 23 patients with posthepatitic cirrhosis and SAA who were treated in the same period. Both groups excluded liver cancer and other malignant tumors. The CT data of two groups of patients were retrospectively analyzed by MSCT image postprocessing. The location, number and size of SAA, the diameter of splenic artery, the diameter of splenic vein, the diameter of portal vein, the thickness of spleen and the diameter of spleen were analyzed retrospectively. Logistic regression model was used to screen the patients with cirrhosis Relationship between PVT and SAA and risk factors. Results In the observation group of 13 cases, 23 aneurysms were found, 8 cases were single and 5 cases were multiple. They occurred in the middle of the splenic artery and 20 in the distal segment of the splenic artery. In the control group of 23 cases, 38 aneurysms were found, 16 cases were single and 7 cases were multiple. Seven cases occurred in the middle of the splenic artery and 31 in the distal segment of the splenic artery. There were no significant differences in SAA short diameter, splenic artery internal diameter, splenic vein internal diameter and portal vein diameter between the two groups (P> 0.05). The spleen thickness in the observation group was significantly higher than that in the control group [(6.40 ± 1.03) cm vs. (5.30 ± 1.19) cm , P <0.01]. The diameter of spleen in the observation group was higher than that in the control group (P <0.05). Logistic regression analysis showed that spleen thickness was an independent risk factor for cirrhosis with PVT and SAA (OR = 0.373, P <0.05). Conclusions MSCT image postprocessing technique can be used to predict and assess the risk of cirrhosis with PVT and SAA.