Value of CT/MRI in predicting portal vein thrombosis in patients with hepatic fibrosis /cirrhosis after splenectomy
10.3877/cma.j.issn.2095-3232.2018.03.015
- VernacularTitle:CT/MRI在预测肝纤维化/肝硬化脾切除术后门静脉血栓形成中的价值
- Author:
Jun WU
1
;
Min SHEN
;
Yao ZHANG
;
Jin WANG
;
Sichi KUANG
Author Information
1. 中山大学附属第三医院放射科
- Keywords:
Tomography;
spiral computed;
Magnetic resonance imaging;
Liver cirrhosis;
Splenectomy;
Thrombosis;
Portal vein
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2018;7(3):231-235
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the high risk factors of portal vein thrombosis (PVT) after splenectomy and to evaluate CT/MRI in predicting PVT formation.Methods Clinical data of 179 patients with hepatic fibrosis/cirrhosis who underwent splenectomy in the Third Affiliated Hospital of Sun Yat-sen University from January 2005 to March 2016 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 148 males and 31 females with the mean age of (44±12) years old. PVT was diagnosed by CT/MRI and the volume of spleen and the diameter of portal vein were measured. The patients were divided into PVT group (n=77) and control group (n=102) according to the formation of PVT or not after operation. Single factor analysis and multivariate Logistic regression were used to analyze the independent risk factors of PVT formation. The predictive value of CT/MRI for the risk of PVT formation was determined according to the distribution of spleen volume and portal vein diameter of patients.Results Multivariate Logistic regression analysis showed that preoperative spleen volume, portal vein diameter, PT, operative procedure and the D-value of pre- and post-operative PltΔP7 andΔP14 were the independent influencing factors of PVT formation (OR=4.563, 4.443, 4.369, 3.094, 2.117, 1.378; P<0.05). The risk of PVT formation after splenectomy increased significantly when the preoperative spleen volume was≥1100 cm3 or the portal vein diameter was≥17 mm (χ2=25.470, 16.820; P<0.05).Conclusions There are many complicated factors affecting PVT formation after splenectomy in patients with simple hepatic fibrosis/cirrhosis. Preoperative CT/MRI measurement of spleen volume and portal vein diameter can provide important information in predicting the risk of PVT formation.
