中文摘要：

目的探讨肝纤维化、肝硬化门静脉高压的CT征象与病理分期的关系。方法对经肝穿刺病理活检确诊的肝纤维化S1期12例、S2期14例、S3期9例、S4期13例、典型肝硬化16例以及20例对照组行16层螺旋CT上腹部3期增强容积扫描，于门静脉期最大密度投影（MIP）图像上分别测量门静脉左支、门静脉右支、门静脉主干（MPV）、脾静脉（SV）和肠系膜上静脉（SMV）的管径，并观察各组门静脉侧支循环开放情况及有无腹水和脾脏肿大，将上述指标与病理分期作对照研究。门静脉系统各血管管径的比较采用单因素方差分析，组间两两比较用SNK法；多组腹水及侧支循环发生率的比较采用R×C表χ^2检验，组间行χ^2分割计算；运用Logistic回归分析探讨门静脉系统中对肝纤维化病理分期影响最大的血管。结果对照组门静脉左支、门静脉右支、MPV、SV和SMV的管径分别为（0．98±0．11）、（1．00±0．12）、（1．33±0．11）、（0．75±0．10）和（1．07±0．12）cm，脾脏体积为（128．55±30．56）cm^3，无侧支循环开放和腹水。S1、S2、S3期组、S4期组或早期肝硬化组、典型肝硬化组SV管径逐渐增大，分别为（0．86±0．12）、（0．96±0．11）、（1．07±0．08）、（1．09±0．10）和（1．18±0．19）cm，各组与对照组间比较，差异均有统计学意义（P〈0．05），重度肝纤维化（S3期组和S4期组）、典型肝硬化以及轻度肝纤维化（S1期组和S2期组）间差异均有统计学意义（P〈0．05）。Logistic回归分析显示，在门静脉各血管测量指标中，SV的标准化回归系数最大（2．719），且差异有统计学意义（P〈0．01）。典型肝硬化的侧支循环开放及腹水发生率明显高于正常肝脏和肝纤维化各期，S4期的侧支循环出现率明显高于对照组、S1期组及S2期组。结论当慢性肝病发展至重度肝纤维化或早期肝硬化时，CT检?

英文摘要：

Objective To investigate the relationship between CT signs of portal hypertension and histopathologic stage of chronic hepatic fibrosis and cirrhosis. Methods Tri-stage enhance volume CT scan of upper abdomen was performed in 84 participants, including 48 patients with hepatic fibrosis confirmed by liver pathologic biopsy which divided into S1 （ 12/48 ）, S2 （ 14/48 ）, S3 （ 9/48 ） and S4 （ 13/48 ）, 16 patients with typical cirrhosis, and 20 healthy subjects as a control group. Measured the caliber of left and right branch of portal vein, MPV, SV and SMV at MIP images respectively, observed the collateral circulation, ascites and the size of spleen and then studied comparatively these measured parameters of different histopathologic stage. One-Way ANOVA was performed in the comparison of the vascular diameter of portal system and the size of spleen（SNK was used in the comparison between the groups）. χ^2 test of R x C table was performed in the comparison of ascites and collateral circulation among groups, and the vessel of portal system which has the greatest impact on the pathological staging of hepatic fibrosis was investigated with Logistic regression analysis. Results The caliber of left branch of portal vein, right branch of portal vein, MPV, SV and SMV were （0.98±0.11）, （1.00 ±0.12）, （1.33 ±0.11）, （0.75 ±0.10）, （ 1.07 ±0. 12） cm respctively, the size of spleen was （ 128. 55± 30. 56） cm^3, and collateral circulation and ascites were not found in control group. SV enlarged gradually in test groups and showed S1 （0. 86 ± 0. 12） cm, S2（0.96 ±0. 11） cm, S3（1.07±0.08） cm, S4（1.09±0. 10） cm, typical cirrhosis （1.18±0. 19） cm respctively. The difference between each group of S1 to typical cirrhosis and control group was significant, and the same result was seen among S3 to S4, cirrhosis and S1 to S2. Logistic regression analysis showed that the standardized regression coefficient of SV was maximum （2. 719 ） and had statistical significanc