摘要
目的探讨肝硬化患者肾脏损害的CT表现,并对其影响因素进行研究。方法对60例经临床、实验室和影像学检查证实为肝硬化的患者和同期20例无肝肾疾患及其它相关疾病的患者行肾脏多层螺旋CT增强扫描,测量双肾皮质厚度,实质厚度,皮质厚度与实质厚度比,动脉期皮质、髓质强化程度。对肝硬化组肝功能不同Child-Pugh分级、不同腹水量、不同肝硬化类型、有无侧枝循环开放及脾静脉与左肾静脉有无交通间各测量指标进行亚组分析。结果肝硬化组皮质厚度与实质厚度比、动脉期皮质强化程度均较对照组低(P<0.05),髓质强化程度较对照组高(P<0.05)。随着肝功能Child-Pugh分级的增高、侧枝循环开放及脾静脉与左肾静脉交通,皮质强化程度逐渐减低(P<0.05),而髓质强化程度、肾皮质实质厚度比无明显变化(P>0.05);不同腹水量及不同肝硬化类型间上述指标的差异无统计学意义(P>0.05)。结论肝硬化患者肾脏损害的CT表现包括肾皮质厚度与实质厚度比减小、肾皮质强化程度减低、髓质强化程度增加等;其中肾皮质强化程度减低尤为重要,主要的影响因素包括肝功能损害的程度、有无侧枝循环开放及脾静脉与左肾静脉的是否交通。
Objective To use CT to identify renal damage in patients with liver cirrhosis.Methods Sixty patients with liver cirrhosis confirmed by clinical,laboratory and imaging examinations and 20 patients without liver and kidney diseases（control group） were recruited in this study.The participants underwent double-stage enhanced scanning.The thickness of renal cortex（C） and parenchyma（P）,and enhancement of renal cortex and medulla on cortical phase were measured.The association between renal damage and Child-Pugh grades,ascites capacities,liver cirrhosis types,opened portal collateral vessels,and opened collateral vessels between splenic venous and renal venous in the patients with liver cirrhosis were analysed.Results The patients with liver cirrhosis had lower C/P and enhancement of cortex on cortical phase and greater enhancement of medulla than the controls（P〈0.05）.The enhancement of cortex decreased with the increase of Child-Pugh grade,opened portal collateral vessels and opened collateral vessels between splenic venous and renal venous（P〈0.05）,but the differences of enhancement of medulla and C/P had no statistical significance（P〉0.05）.No differences in the measured indicators were found between patients with different capacities of ascites and patients with different types of liver cirrhosis（P〉0.05）.Conclusion The CT findings on renal damage in patients with liver cirrhosis include decrease in C/P and enhancement of cortex on cortical phase,and increase in enhancement of medulla on cortical phase.The enhancement of cortex on cortical phase is the most important change,which is associated with Child-Pugh grades,opened portal collateral vessels and opened collateral vessels between splenic venous and renal venous.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2009年第6期1115-1118,共4页
Journal of Sichuan University(Medical Sciences)
