| 双能量CT碘定量结合动态对比增强MRI评估肝硬化患者肝脏血流动力学和肝功能临床价值研究* |
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| 引用本文： | 金良红,李兴杰,关红博,麻少辉. 双能量CT碘定量结合动态对比增强MRI评估肝硬化患者肝脏血流动力学和肝功能临床价值研究*[J]. 实用肝脏病杂志, 2019, 22(5): 712-715. DOI: 10.3969/j.issn.1672-5069.2019.05.025 |
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| 作者姓名： | 金良红 李兴杰 关红博 麻少辉 |
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| 作者单位： | 725000 陕西省安康市人民医院放射科（金良红,李兴杰,关红博）; 西安交通大学第一附属医院影像科（麻少辉） |
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| 基金项目： | 陕西省自然科学基金资助项目（编号：2783927） |
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| 摘 要： | 目的 探讨双能量CT碘定量结合动态对比增强MRI评估肝硬化患者肝脏血流动力学及肝功能的临床价值。方法 2016年6月~2018年6月我院收治的130例乙型肝炎肝硬化患者和同期在我院检查证实肝脏无异常的健康人30例,行动态对比增强MRI和双能CT增强扫描,测量肝实质血流参数峰值（PV）、最大上升斜率（MSI）、最大下降斜率（MSD）、正性增强积分（PEI）和信号增强率（SER）,计算动脉期肝实质碘浓度（Ia）、门静脉期肝实质碘浓度（Ip）、肝动脉碘分数（AIF）和门静脉碘浓度（PVIC）。结果 肝硬化组肝实质PV值为（522.1±96.7）,显著低于对照组【（609.2±108.8）,P<0.05】,肝实质PEI值为（200.2±53.3）,显著低于对照组【（241.3±61.5）,P<0.05】;15例CTP C级患者肝实质的PV值为（443.4±57.3）,显著低于89例CTP A级【（587.4±94.5）,P<0.05】,MSI值为（170.1±54.6）,显著低于CTP A级【（310.6±69.5）,P<0.05】,MSD值为（31.9±22.5）,显著低于CTP A级【（67.8±19.6）,P<0.05】,PEI值为（155.6±29.7）,显著低于CTP A级【（236.7±53.4）,P<0.05】,SER值为（109.3±7.5）,显著低于CTP A级【（125.6±13.5）,P<0.05】;26例CTP B级患者Ia值为（0.7±0.2） mgI/ml,C级患者Ia值为（0.8±0.2） mgI/ml,显著高于健康人【（0.5±0.1） mgI/ml,P<0.05】,CTP A级Ip值为（2.2±0.5） mgI/ml,B级为（2.0±0.5） mgI/ml、C级为（1.8±0.3） mgI/ml,显著低于健康人【（2.6±0.6） mgI/ml,P<0.05】,CTP B级AIF值为（31.7±5.0） %、C级为（47.8±8.9） %,显著高于健康人【（21.1±4.3） %,P<0.05】。结论 双能量CT碘定量结合动态对比增强MRI检查评估肝硬化患者肝脏血流动力学结果可靠,灌注参数的变化能反映肝功能储备情况。
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| 关 键 词： | 肝硬化 血流动力学 双能量CT 磁共振成像 灌注参数 |
| 收稿时间： | 2019-01-17 |
Clinical value of dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI in evaluating hepatic hemodynamics and liver functions in patients with hepatitis B liver cirrhosis |
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| Jin Lianghong,Li Xingjie,Guan Hongbo,et al. Clinical value of dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI in evaluating hepatic hemodynamics and liver functions in patients with hepatitis B liver cirrhosis[J]. Journal of Clinical Hepatology, 2019, 22(5): 712-715. DOI: 10.3969/j.issn.1672-5069.2019.05.025 |
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| Authors: | Jin Lianghong Li Xingjie Guan Hongbo et al |
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| Affiliation: | Department of Radiology,People's Hospital,Ankang 725000,Shaanxi Province,China |
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| Abstract: | Objective The purpose of this study was to explore the clinical value of dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI in evaluating liver hemodynamics and liver functions in patients with hepatitis B-induced liver cirrhosis （LC）. Methods 130 patients with hepatitis B cirrhosis and 30 individuals with normal liver function tests were recruited in our hospital between June 2016 and June 2018. The dynamic contrast-enhanced MRI scan and dual-energy CT enhanced scan were performed and the blood flow parameter peak （PV）,maximum rise slope（MSI）,maximum drop slope （MSD）,positive enhancement integral （PEI） and signal enhancement rate （SER） in the liver parenchyma were measured. The liver iodine concentration （Ia）,portal iodine concentration （Ip）,hepatic artery iodine fraction（AIF）,and portal iodine concentration （PVIC） were also calculated. Results The PV value of liver parenchyma in patients with LC was（522.1±96.7）,significantly lower than [（609.2±108.8）,P<0.05] in the control,and the liver parenchymal PEI value was （200.2±53.3）,significantly lower than [（241.3±61.5）,P<0.05] in the control;the PV value in 15 patients with CTP class C was（443.4±57.3）,significantly lower than [（587.4±94.5）,P<0.05] in 89 patients with CTP class A,the MSI value was（170.1±54.6）,significantly lower than [（310.6±69.5）,P<0.05] in patients with CTP class A,the MSD value was（31.9±22.5）,significantly lower than [（67.8±19.6）,P<0.05] in patients with CTP class A, the PEI value was （155.6±29.7）,significantly lower than [（236.7±53.4）,P<0.05] in patients with CTP class A,and the SER value was （109.3±7.5）,significantly lower than[（125.6±13.5）,P<0.05] in patients with CTP class A;the Ia value in 26 patients with CTP class B was （0.7±0.2） mgI/ml,in class C was （0.8±0.2） mgI/ml,both significantly higher than 【（0.5±0.1） mgI/ml,P<0.05】 in the control,and the Ip value in patients with CTP A was （2.2±0.5） mgI/ml,in patients with class B was （2.0±0.5） mgI/ml,in patients with class C was（1.8±0.3） mgI/ml,all significantly lower than 【（2.6±0.6） mgI/ml,P<0.05】 in the control,and AIF in patients with CTP class B was（31.7±5.0） %,and in those with class C was（47.8±8.9）%,both significantly higher than 【（21.1±4.3） %,P<0.05】 in the control. Conclusion Dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI is useful in clinical practice,which might help evaluate hepatic hemodynamics in patients with liver cirrhosis. |
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| Keywords: | Liver cirrhosis Hemodynamics Dual energy CT Magnetic resonance imaging Perfusion parameters |
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