【作者】 罗小华；

【导师】 宋彬； 刘荣波； 陈卫霞；

【作者基本信息】 四川大学 ， 影像医学与核医学， 2004， 硕士

【摘要】 [目的] 描述慢性乙型病毒性肝炎的各种CT表现,探讨其CT征象与肝炎严重程度、预后评估之间的相关性,评价CT检查在慢性病毒性肝炎中的应用价值。 [材料和方法] 按照纳入与排除标准,回顾性收集慢性乙型病毒性肝炎120例的全部临床与实验室资料,其中轻度肝炎34例,中度肝炎22例,重度肝炎26例,重症肝炎38例。全部病例均经标准化的螺旋CT增强双期扫描,并由两名熟练专业影像医师阅片,着重观察和记录肝脏本身、胆道系统、门静脉系统、上腹部淋巴结状态、腹腔/胸腔等的形态学改变,将上述CT征象与临床及实验室指标作相关分析。 [结果] 1、慢性乙型病毒性肝炎的异常CT表现包括:①肝脏质地不均、密度降低;②肝脏外形、轮廓不光滑;③肝脏内血管周围“晕环征”;④胆囊壁增厚和胆囊窝水肿;⑤脾脏增大;⑥腹腔淋巴结肿大、增多;⑦腹腔积液;⑧侧支循环建立等肝硬化表现;⑨继发胸部改变(胸膜增厚、更多还原

【Abstract】 [Purpose] To investigate the CT manifestations of chronic viral hepatitis and to address the relationship between CT features and the severity of chronic viral hepatitis.[Materials and Methods] According to the inclusion and exclusion criteria, the clinical data and laboratory information of 120 patients with chronic virus hepatitis were reviewed retrospectively. They were classified into mild (34 cases), moderate (22), severe hepatitis (26) and hepatitis gravis (38) respectively based on international standardized clinical criteria. All patients underwent standardized contrast-enhanced spiral CT dual-phase scanning of the upper abdomen. CT images were interpreted by two experienced radiologists through consensus reading. The morphological changes of the liver, bile duct, portal venous system, lymph node of the upper abdomen, peritoneal cavity and pleural cavity were observed and noted. Correlation analysis was applied for the relationship of CT imaging features and the severity indices of chronic hepatitis.[Results] (1) CT manifestations of chronic viral hepatitis were as follows: ?changes of the configuration and shape of the liver, ? changes of the density of the liver, ?intrahepatic perivascular lucency, ?thickening of gallbladder wall and edema of the gallbladder fossa, ?splenomegaly, ?enlargement of abdominal lymph nodes, ?ascites, ?abnormalities related to portal hypertension (collateral circulation), ?secondary thoracic changes (pleural and pericardial effusion). (2) There was some close association between certain CT features of chronic hepatitis and the clinical status of chronic hepatitis. With the progression and deterioration of chronic hepatitis, serum albumin level went down and value of ALT went up, the incidences of ? intrahepatic perivascular lucency, ?edema of the gallbladder fossa, ? enlargement of abdominal lymph nodes, ? ascites and ?secondary and thoracic changes increased markedly. Correlation between these CT manifestations and clinical severity of chronic viral hepatitis was of statistical significance.[Conclusions] Chronic viral hepatitis can demonstrate several abnormal findings on contrast-enhanced CT scanning. To certain extent, some CT features, such as intrahepatic perivascular lucency, edema of gallbladder fossa, enlargement of abdominal lymph nodes, ascites and secondary thoracic changes, can reflect the clinical severity of chronic viral hepatitis.更多还原