CT增强扫描诊断脂肪肝的新认识

摘要

Objective To evaluate the value of enhanced CT in the diagnosis of fatty liver disease. Methods From January 2014 to May 2016,CT data of 105 patients with fatty liver disease were collected and CT values of the liver and spleen were measured on plain scan and enhanced venous phase and then the liver/splee ratios were calculated.Liver/spleen ratio<1 on the venous phase was the cutoff value for the diagnosis of the fatty liver disease and its diagnostic specificity was calculated. Results Among 105 patients with fatty liver disease,mean CT value of liver and spleen on plain scan was(28.4±13.5)HU and(48.6±5.0)HU with the liver/spleen ratio<1(n=105). While the mean CT value of liver and spleen on enhanced venous phase scan was(68.5±16.2)HU and(102.1±16.0)HU with the liver/spleen ratio<1(n=105). Conclusions The liver/spleen<1 on venous phase enhanced CT can be diagnosed as the diagnostic clue for fatty liver disease and enhanced CT can more clearly display heterogeneous fatty liver disease and occult lesion.%目的 探讨脂肪肝CT增强扫描的诊断意义.方法 收集2014年1月至2016年5月期间诊断为脂肪肝的患者105例,分别测量平扫及增强门脉期的肝脏、脾脏CT值,计算两者肝脏/脾脏的CT值之比,将平扫及增强门脉期比值进行分析,计算当增强门脉期肝/脾比<1时诊断脂肪肝的特异性.结果 105例患者,平扫肝脏CT值平均为(28.4±13.5)HU(-16~51HU),脾脏CT值平均为(48.6±5.0)HU(37~69HU),二者比值<1共105例(100%);增强门脉期肝脏CT值平均为(68.5±16.2)HU(29~103HU),脾脏CT值平均为(102.1±16.0)HU(66~167HU),二者比值<1者共105例(100%);计算以增强门脉期肝/脾比<1时诊断脂肪肝的特异性为100%(105/105).结论 脂肪肝CT增强门脉期肝/脾CT值之比可以用于脂肪肝的诊断,相比于平扫脂肪肝的诊断标准,能更好识别不均质脂肪肝和肝内隐匿性病变,更真实的反应肝脏脂肪浸润的程度,同时能更好的鉴别不均质脂肪肝.