| 顾小秋,杜合娟.多层螺旋 CT血管造影在原发性肝癌肝动脉－门静脉瘘诊断中的应用[J].安徽医药,2021,25(9):1835-1838. |
| 多层螺旋 CT血管造影在原发性肝癌肝动脉－门静脉瘘诊断中的应用 |
| Application of multi-slice spiral CT angiography in diagnosing hepatic artery-portal vein fistula in primary hepatic carcinoma patients |
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| DOI：10.3969/j.issn.1009-6469.2021.09.032 |
| 中文关键词: 肝肿瘤 动静脉瘘 原发性肝癌 肝动脉 -门静脉瘘 多层螺旋 CT血管造影 数字减影血管造影 危险因素 |
| 英文关键词: Liver neoplasms Arteriovenous fistula Primary hepatic carcinoma Hepatic artery-portal vein fistula Multi-slice spiral CT angiography Digital subtraction angiography Risk factors |
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| 中文摘要: |
| 目的分析多层螺旋 CT血管造影( MSCTA)诊断原发性肝癌( PHC)病人肝动脉－门静脉瘘( HAPVF)的价值及影响 HAPVF发生危险因素。方法选择无锡市第五人民医院 2017年 9月至 2019年 4月收治的 129例 PHC病人作为研究对象，根据是否并发 HAPVF分为 HAPVF组和非 HAPVF组。统计 PHC病人 HAPVF的发生情况，并以 DSA检查结果为“金标准”分析 MSCTA评估 PHC病人 HAPVF的准确性，此外分析与 HAPVF发生相关的危险因素。结果 129例 PHC病人经 DSA检查检查，共发现 40例 HAPVF(占 31.0%)其中周围型 17例(占 42.5%)中央型 23例(占 57.5%)；经 MSCTA检查 37例 HAPVF病人获得了正确分型诊断，诊断准确率为92，.5%(37/40)，与 DSA检查结果，表现出良好的一致性( Kappa=0.85)；单因素分析初步筛选出了 4个(肝功能 Child-Pugh分级、肿瘤数目、肿瘤最大径、合并肝硬化)与 PHC病人并发 HAPVF有关的因素；多因素 logistic回归分析显示肝功能 Child-Pugh分级( OR=10.341，P<0.001)、肿瘤最大径( OR=3.385，P=0.037)、合并肝硬化( OR=4.440，P=0.028)为PHC病人并发 HAPVF的危险因素。结论 PHC病人出现 HAPVF的发生率高， MACTA可发现 HAPVF并对其分型做出正确评估，能用于指导治疗。此外，肝功能 Child-Pugh分级、肿瘤最大径、合并肝硬化等均为影响 PHC病人并发 HAPVF的危险因素。 |
| 英文摘要: |
| Objective To analyze the value of multi-slice spiral CT angiography (MSCTA) in diagnosing hepatic artery portal venous fistula (HAPVF) in primary hepatic carcinoma (PHC) patients and the risk factors influencing HAPVF.Methods A total of 129 PHC patients admitted to Wuxi Fifth People's Hospital from September 2017 to April 2019 were selected as the study objects, and were divided into HAPVF group and non-HAPVF group according to whether they were complicated with HAPVF or not. The occurrence ofHAPVF in PHC patients was statistically analyzed, and the DSA examination results were taken as the "gold standard" to analyze theaccuracy of MSCTA in evaluating HAPVF in PHC patients, and the risk factors related to the occurrence of HAPVF were also analyzed.Results A total of 40 cases of HAPVF (31.0%) were found in 129 PHC patients by DSA examination, including 17 cases of peripheraltype (42.5%) and 23 cases of central type (57.5%); After MSCTA examination, 37 HAPVF patients obtained the correct classificationdiagnosis, and the diagnostic accuracy was 92.5% (37/40), which showed good consistency with DSA examination results (Kappa value =0.85); Single factor analysis initially screened out 4 factors (child-pugh grading of liver function, number of tumors, maximum tumor diameter, combined with cirrhosis) related to HAPVF in PHC patients; Multivariate logistic regression analysis showed that childpugh grading of liver function (OR=10.341,P<0.001), maximum tumor diameter (OR=3.385,P=0.037), and combined cirrhosis (OR= 4.440,P=0.028) were risk factors for HAPVF in PHC patients.Conclusions The incidence of HAPVF in PHC patients is high, andMACTA can discover HAPVF and make a correct assessment of its classification for therapeutic guidance. In addition, Child-Pughgrading of liver function, maximum tumor size and combined cirrhosis are all risk factors affecting the complication of HAPVF in PHCpatients. |
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