目的 对CT平扫及增强检查对肝 硬化门脉高压伴脾功能亢进的应用价值 进行探讨分析，为临床预测和评估PHT伴 脾亢疾病提供有效合理的基础依据。方 法 随机抽取2015年1月到2015年12月期 间接受医院治疗的PHT伴脾亢患者72例， 在患者自愿的前提下对PHT伴脾亢患者先 进行CT平扫(平扫组)，后进行增强CT扫 描(增强组)，对两组患者的疾病阳性检 查率、临床诊断效果及脏器内部结构病 变情况进行定期临床随访、统计实验检 测数据分析影像学图像分析及记录详细 临床信息。结果 与平扫组相比，增强组 中的重症PHT伴脾亢阳性率明显较高，差 异具有统计学意义(P＜0.05)。对CT平扫 与增强CT扫描两种检查方式诊断效果(灵 敏度、特异度、阳性预测率、约登指数) 的情况对比，结果表明增强组在对PHT伴 脾亢组织病变的诊断效果方面更优于平 扫组，且两者差异均具有统计学意义(P ＜0.05)。此外增强CT扫描方式比CT平扫 方式检查获得的影像学图像更为清晰准 确，能为临床疾病诊断和治疗提供了良 好依据。结论 在对PHT伴脾亢患者进行 诊断和治疗时，采取增强CT扫描对于PHT 伴脾亢检查具有快速简便、合理有效、 分辨率高及特异性好的临床效果，具有 较高的临床推广价值。

Objective To explore the effect evaluation of the CT scan and the enhanced CT scan on the cirrhotic portal hypertension and hypersplenism, providing the basis for the clinical treatment of the PHT and hypersplenism disease. Methods A total of 72 cases with PHT with hypersplenism who were treated in the hospital from Jan 2015 to Dec. 2015 were recruited as the study objects, The patients of PHT with hypersplenism were examined by the CT scan (the scan group) firstly and the enhanced CT scan group (the enhanced group) then. The indicators were compared between the two groups, mainly on the positive rate of examination, the clinical effect of diagnosis, and the internal structural lesions of viscera,statisticing the experimental data, analing the radiographic image, and recording the detailed information. Results The positive detection rate of serious PHT with hypersplenism in the enhanced group was significantly higher than that in the scan group, and the difference was statistically significant(P＜0.05). The diagnosis effect (sensitivity, Specific degrees, positive predictive rate, index) in the enhanced group was significantly better than that in the scan group, and the difference was statistically significant(P＜0.05). The radiographic images in the enhanced group was significantly more clear and accurate than that in the scan group, providing a good basis for clinical diagnosis and treatment. Conclusion The enhanced CT scan could be effective for the diagnosis and treatment in the patients with PHT with hypersplenism,which had the clinical effect of high resolution and good specificity, quickly and easily, reasonably and effectively , having the high clinical value.