MSCT评估肝癌伴肝硬化患者肝脏储备功能中的价值分析

目的 探讨MSCT评估肝癌伴肝硬化患者肝储备功能的价值.方法 选取2014年2月至2016年3月在我院治疗的肝癌伴肝硬化患者44例,评价患者治疗前的CT形态学分级和Child-pugh分级,并分析肝脏MSCT灌注参数与二者之间的关系.结果 重度肝硬化患者血流量(blood flow,BF)、血容量(blood volume,BV)、门静脉灌注量(pogal venous liver perfusion,PVP)、对比剂达到时间(contrast agent arrival time,IRF T0)参数显著低于轻度和中度肝硬化患者,平均通过时间(mean transit time,MTT)、肝动脉分数(hepatic arterial fraction,HAF)和A/V参数显著高于轻度和中度肝硬化患者;中度肝硬化患者BF、BV、PVP和IRF TO参数显著低于轻度肝硬化患者,MTT、HAF和A/V参数显著高于轻度肝硬化患者;肝功能Child-pugh C级患者BF、BV和PVP参数显著低于A级和B级患者,HAF和A/V参数显著高于A级和B级患者,C级和B级患者MTT和IRF TO比较差异无统计学意义(P＞0.05);肝硬化形态学分级与BF、BV、IRF TO和PVP呈负相关(r=-0.832、-0.804、-0.703和-0.856,P＜0.05),与MTr、HAF和A/V呈正相关(r=0.602、0.811和0.820,P＜0.05),与肝动脉灌注量(hepatic artery perfusion,HAP)无相关性(P＞0.05);肝功能Child-pugh分级与BF、BV、IRF TO和PVP呈负相关(r=-0.874、-0.835、-0.502和-0.831,P＜0.05),与MTr、HAF和A/V呈正相关(r=0.615、0.754和0.816,P＜0.05),与HAP无相关性(P＞0.05).结论 MSCT可用于肝癌患者肝硬化程度和肝储备功能评估,为肝硬化分级诊断提供重要手段.

Evaluation of Liver Reserve Function in Patients with Liver Cancer and Cirrhosis by MSCT

Objective To investigate the evaluation values of liver reserve function in patients with liver cancer and cirrhosis by using MSCT.Methods 4 patients with liver cancer and cirrhosis treated in our hospital from February 2014 to March 2016 were selected as the objectives,and the CT grade and Child-pugh classification of patients were evaluated before treatments.The relationships between MSCT perfusion parameters and CT grade and Child-pugh classification were analyzed.Results The parameters of BF,BV,PVP and IRF TO in patients with severe liver cirrhosis were significantly lower than patients with mild or moderate cirrhosis,but MTT,HAF,and A/V parameters were significantly higher in patients with severe liver cirrhosis than mild and moderate cirrhosis;The parameters of BF,BV,PVP and IRF TO in patients with moderate liver cirrhosis were significantly lower than those of patients with mild cirrhosis,but the parameters of MTT,HAF and A/V were significantly higher;The parameters of BF,BV and PVP in patients with grade C of Child-pugh were significantly lower than in patients with grade A and B,but HAF and A/V parameters were significantly higher than grade A and B.There was no significant difference of MTT and IRF TO between the grade C and B (P ＞ 0.05);Morphologic classifications of hepatocirrhosis were negatively correlated with BF,BV,IRF TO and PVP(r =-0.832,-0.804,-0.703-0.856,P ＜0.05),but positively correlated with MTT,HAF and A/V (r =0.602,0.811 and 0.820,P ＜ 0.05),and there was no correlation with HAP(P ＞ 0.05);Liver function Child-pugh grading were negatively correlated with BF,BV,IRF TO and PVP (r =-0.874,-0.835,-0.502-0.831,P ＜ 0.05),but positively correlated with MTT,HAF and A/V (r =0.615 and 0.754 and 0.816,P ＜ 0.05),and has no correlation with HAP (P ＞ 0.05).Conclusion MSCT can be used to assess the degree of liver cirrhosis and liver reserve function in patients with liver cancer,and provide an important method for the classification of liver cirrhosis.