| Objective 1 To analyse the application value of multisliecs helieal Computed Tomography(MSCT)in diagnosing different degrees of esophageal varices(EV).2 To find out the critrical reference values of different index diagnosing different degrees of EV.3 To compare the accuracy between the ratio indexes and single index.Methods A total of 100 patients with cirrhotic portal hypertension which all accept the examination of MSCT and endoscopic between September 2014 and September 2017 in the Noth China University of Science and Technology Affiliated Hospital were included in present study.According to endoscopic,100 patients were divided into negative,positive that include mild,moderate and severe.D,d1,d2,LI,or SI of each group was measured by MSCT.PLT of each group was collected.Use the above single index to calculate the ratio indexes including d1/d2,LI/SI,PLT/SI.Database was established by Excel 2003,Spss 23.0 statistical sofeware was used for statistical analysis.1 Used χ2 test and Kappa test to compare the difference both MSCT and endoscopic in diagnosing different degrees of EV.2.Used LSD Duncan to compare the difference of each index among different degrees EV.3.Used receiver operating characteristic(ROC)curve to compare the application value of all indexes in each degree EV.Results 1 There was no statistical significance(χ2=5.152,P=0.525)and had great uniformity(K=0.563,P<0.001)between CT(negative 22,positive 78 that include mild 15,moderate 42 and severe 21)and endoscopic(negative 19,positive 81 that include mild 22,moderate 44 and severe 15)in diagnosing different degrees of EV,that explained MSCT could diagnose different degrees of EV.2 The difference of d,d1,d2,SI,PLT or PLT/SI in each group(negative,mild,moderate and severe)had statistical significance(P<0.05),that explained d,d1,d2,SI,PLT and PLT/SI could diagnose different degrees of EV.LI or d1/d2 was no statistical significance between negative and mild(P>0.05),that explained LI and d1/d2 could not diagnose mild EV.LI or LI/SI was not statistical significance between moderate and severe(P>0.05),that explained LI and LI/SI could not diagnose moderate and severe EV.3 The best accuracy of diagnosing mild EV was d(AUC: 0.884,95%CI: 0.784-0.984,P<0.001).When the value of d was 3.2,MSCT diagnosing mild EV had great sensitivity and specificity(93.8%,68.4%),the difference of MSCT and endoscopic diagnosing mild EV was no statistical significance(χ2=3.125,P=0.289),MSCT and endoscopic had great uniformity in diagnosing mild EV(K=0.602,P<0.001).The result showed that d had high sensitivity and specificity to diagnose mild EV.The best accuracy of diagnosing moderate EV was d(AUC: 0.994,95%CI: 0.984-1.000,P<0.001).When the value of d was 3.9,MSCT diagnosing moderate EV had great sensitivity and specificity(90.9%,95.1%),the difference of MSCT and endoscopic diagnosing mild EV was no statistical significance(χ2=0.167,P=0.687),MSCT and endoscopic had great uniformity in diagnosing mild EV(K=0.859,P<0.001).The result showed that d had high sensitivity and specificity to diagnose moderate EV.The best accuracy of diagnosing severe EV was d(AUC: 0.970,95%CI: 0.940-1.000,P<0.001).When the value of d was 6.0,MSCT diagnosing severe EV had great sensitivity and specificity(93.3%,96.5%),the difference of MSCT and endoscopic diagnosing mild EV was no statistical significance(χ2=2.250,P=0.625),MSCT and endoscopic had great uniformity in diagnosing mild EV(K=0.851,P<0.001).The result showed that d had high sensitivity and specificity to diagnose severe EV.Conclusion 1 MSCT can diagnose different degrees of esophageal varices(EV).2 The best CT index of diagnose different degrees of EV is d.As the degree of EV increases,d widens.When the value of d is 3.9,d has high sensitivity and specificity(90.9%,95.1%)to diagnose moderate EV.When the value of d is 6.0,d has high sensitivity and specificity(93.3%,96.5%)to diagnose severe EV.3 The accuracy of the ratio index is not all better than the single index.Among the three ratio index,there is only PLT/SI the accuracy of that is higher than the single index. |
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