本文關(guān)鍵詞： 肝小靜脈閉塞病 布加綜合征 肝炎后肝硬化 數(shù)字減影血管造影　出處：《大連醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：收集肝小靜脈閉塞病(hepatic veno-occlusive disease，HVOD)10例、布加綜合征（Budd-chiari Syndrome，BCS）10例、肝炎后肝硬化20例，測量其門靜脈主干直徑等，以判斷3組間是否有統(tǒng)計學(xué)差異。分析10例HVOD患者CT征象，并將其CT門靜脈三維重建表現(xiàn)與數(shù)字減影血管造影(digital subtractionangiography，DSA)進行對比性研究，探討CT檢查及其后處理重建技術(shù)在HVOD診斷及其鑒別診斷中的應(yīng)用價值。 材料與方法：回顧性分析了3組患者（HVOD10例、BCS10例、肝炎后肝硬化20例）臨床及影像資料。①觀察3組患者CT平掃及其增強表現(xiàn)，包括三維重建后影像學(xué)特征，以及3組疾病側(cè)支循環(huán)情況等；其中HVOD組CT三維重建表現(xiàn)與DSA影像相對比。②測量HVOD患者門靜脈主干直徑與正常值進行比較；③測量3組受檢者的門靜脈主干、左右支、脾靜脈直徑，應(yīng)用成組設(shè)計方差分析（ANOVA），并進一步應(yīng)用（LSD-t檢驗）進行兩兩對比，觀察是否有統(tǒng)計學(xué)意義；④收集做CT及DSA的患者30例患者，觀察（CT測量）門靜脈直徑與（DSA）門靜脈壓力有無相關(guān)。 結(jié)果：①CT三維重建與DSA圖像相符合（門靜脈、側(cè)支循環(huán)方面），肝靜脈顯示方面，DSA優(yōu)于CT；側(cè)支循環(huán)顯示情況：平均HVOD組：1.2支，BCS組：2.5支，肝炎后肝硬化組：2.1支。②HVOD患者門靜脈主干平均值，比正常值略低；③門靜脈左支、右支:HVOD與BCS組(LSD-t檢驗)之間無統(tǒng)計學(xué)差異。其余門靜脈主干、左右支、脾靜脈，3組間兩兩比較，兩組間對比有統(tǒng)計學(xué)意義（P0.05）；④CT測量門靜脈直徑與DSA測量的門靜脈壓力之間無相關(guān)。 結(jié)論：首先，CT增強掃描可以將典型的HVOD、BCS患者，，與肝炎后肝硬化鑒別開來。而CT三維重建技術(shù)可以對HVOD與BCS進行進一步的鑒別，其次，三維重建中門靜脈直徑、側(cè)支循環(huán)情況等，與DSA相符合，可以對疾病進行輔助性診斷。最后，詳細了解病史、臨床表現(xiàn)、實驗室檢查、其他輔助檢查等一般資料，在鑒別診斷中也占有十分重要的地位�？傊�，CT檢查對HVOD的診斷及其與BCS、肝炎后肝硬化的鑒別診斷有一定的臨床價值。
[Abstract]:Objective: to collect 10 cases of hepatic veno-occlusive disease (veno-occlusive) with HVODN. The diameter of portal vein trunk was measured in 10 cases of Budd-chiari Syndrometerus syndrome and 20 cases of posthepatitic cirrhosis. In order to judge whether there were statistical differences among the three groups, the CT signs of 10 cases of HVOD were analyzed. The CT portal vein 3D reconstruction was compared with digital subtraction angiography (DSA). To evaluate the value of CT and post-processing reconstruction in the diagnosis and differential diagnosis of HVOD. Materials and methods: the clinical and imaging data of 10 patients with HVOD10 patients with BCS and 20 patients with posthepatitic cirrhosis were retrospectively analyzed. The imaging features after 3D reconstruction and collateral circulation in 3 groups were included. Ct 3D reconstruction in HVOD group was compared with DSA imaging. 2 the diameter of portal vein in HVOD patients was measured and the normal value was compared. 3The diameter of portal vein, left and right branches and splenic vein were measured in 3 groups. ANOVAN was used to design ANOVAN in group, and LSD-t test was used to make a pairwise comparison. Observe whether there is statistical significance; 4Thirty patients with CT and DSA were collected. The diameter of portal vein was measured by CT. Results Three-dimensional reconstruction of 1: 1 CT was consistent with DSA images (portal vein, collateral circulation, hepatic vein display). Collateral circulation: the mean value of portal vein trunk in HVOD group was slightly lower than that in normal group, and the mean value of portal vein trunk was slightly lower in HVOD group (1: 1.2 branch) than in control group (2: 2.5 branches) and in posthepatitic cirrhosis group (1. 1 branch 路2. 2 HVOD group). 3There was no significant difference between the left portal vein, the right branch and the BCS group (LSD-t test), but the other portal vein trunk, left and right portal vein, splenic vein were compared in two groups. There was significant difference between the two groups (P 0.05). 4 there was no correlation between the diameter of portal vein measured by CT and the pressure of portal vein measured by DSA. Conclusion: first of all, enhanced CT scan can be used in typical patients with HVODV BCS. Ct 3D reconstruction can be used to differentiate HVOD from BCS. Secondly, the diameter of portal vein and collateral circulation in 3D reconstruction can be further distinguished. In accordance with DSA, we can make auxiliary diagnosis of the disease. Finally, we can understand the history, clinical manifestation, laboratory examination, other auxiliary examination and other general data in detail. All in all, CT examination has certain clinical value in the diagnosis of HVOD and the differential diagnosis of posthepatitic cirrhosis.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R816.5;R575

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