Radiology:CT定量肝表面结节在检出门静脉高压的价值

2019-04-03 shaosai MedSci原创

本研究旨在验证肝表面结节(LSN)定量评价是否能够对肝硬化患者临床重度门静脉高压(CSPH)具有提示价值。

本研究旨在验证肝表面结节(LSN)定量评价是否能够对肝硬化患者临床重度门静脉高压(CSPH)具有提示价值。

本研究共纳入了189例肝硬化患者作为训练组,78例患者作为验证组,并行腹部CT和肝门静脉压力梯度(HVPG)评价。体积LSN评分、肝和脾体积、肝脾体积比、血小板计数-脾直径比例、Iranmanesh评分、天冬氨酸氨基转移酶-血小板比率指数,肝硬化-4指数。利用ROC曲线下面积评价不同检出方法预测CSPH的准确率,利用Delong检验进行比较。

共分析了189例患者。共有102例患者出现CSPH。LSN评分与HVPG具有相关性(r = 0.75; P < .001)。CSPH患者的LSN评分要高于无CSPH患者(3.2 ± 0.6 vs 2.4 ± 0.3; P < .001)。LSN最佳截断值为0.88 ± 0.03。该指标要的诊断准确率要高于其他指标(DeLong, all P < .001)。在验证组,LSN评分为2.8与86%为CSPH具有阳性预测价值,ROC曲线下面积为0.87 ± 0.04。

本研究表明,基于CT肝表面结节评分对检出临床明显门静脉高压具有较高的诊断价值,其高于其他非侵入性指标。

原始出处:

Sartoris R, Rautou PE, Elkrief L,et al.Quantification of Liver Surface Nodularity at CT: Utility for Detection of Portal Hypertension.Radiology.DOI:10.1148/radiol.2018181131

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