肝脏CT灌注成像与肝硬化程度的关系

目的:利用多层螺旋CT进行肝脏血流灌注,初探不同程度的肝硬化血流灌注参数变化。方法:对10例不同程度的肝硬化患者以及8例对照者,选取肝门区良好显示脾脏、门脉主干、肝脏左右叶的层面,行CT同层动态增强扫描,绘制时间-密度曲线,计算肝脏灌注参数。结果:正常组肝动脉灌注量(HAP)为(0.341 1±0.138 7)ml.min-1.ml-1,门脉灌注量(PVP)为(1.105 2±0.369 7)ml.min-1.ml-1,总肝灌注量(THBF)为(1.450 3±0.445 6)ml.min-1.ml-1,肝动脉灌注指数(HAI)为(23.42±5.94)%。肝硬化严重程度不同时,Child-Pugh A、B、C 3组肝动脉灌注量均较正常组增高,但组间呈逐渐下降趋势,分别为(0.467 7±0.158 8,0.447 8±0.100 4,0.436 7±0.094 2)ml.min-1.ml-1;门脉灌注量和总肝灌注量均较正常组下降,组间呈下降趋势,分别为(0.921 4±0.179 3,0.845 6±0.158 6,0.745 3±0.119 1)ml.min-1.ml-1,(1.397 8±0.324 1,1.568±0.204 6,1.158 6±0.168 4)ml.min-1.ml-1;肝动脉灌注指数则较正常组逐级升高(30.21±4.66,34.88±4.79,37.08±4.13)%。结论:多层螺旋CT肝硬化肝脏血流灌注参数的变化与肝硬化的程度相关。

Relationship between liver perfusion imaging of CT and severity of hepatic cirrhosis

Objective：Mulidetector CT was used to take a liver perfusion and to get the variation of parameters of perfusion in patients with hepatic cirrhosis. Methods： Slices of spleen, main portal vein and liver were chosen, which were from 10 cases of patients with hepatic cirrhosis and 8 cases of control group, and a same layer dynamic enhanced scan was taken, a time-density curve chart was plotted, the parameters of perfusion correlate was calculated. Results：In control group, hepatic arterial perfusion（HAP） was （0. 3411±0. 1387）ml ·min^-1 · ml^- 1 , portal vein perfusion（PVP） was （1. 1052±0. 3697）ml ·min^-1 · ml^- 1 , total hepatic blood flow（THBF） was （ 1. 4503 ±0. 4456） ml ·min^-1 · ml^- 1 , hepatic arterial infusion （ HAD was （ 23.42 ±5. 94） %. When the severity of hepatic cirrhosis changes, HAPs of group A, B, C（Child-Pugh stages） increased, but decreased interclass, which were （0. 4677±0. 1588, 0. 4478±0. 1004, 0. 4367±0. 0942） ml·min^-1 · ml^- 1 ; PVPs and THBFs also decreased interclass, which were （0. 9214±0. 1793,0. 8456±0. 1586,0. 7453±0. 1191）ml·min^-1 · ml^- 1 and （1. 3978±0. 3241, 1.568±0.2046,1.1586±0. 1684）ml·min^-1 · ml^- 1;HAis increased, which were （30. 21±4. 66, 34.88±4.79,37.08±4. 13） %. Conclusion：The variation of parameters of perfusion correlates with the severity of hepatic cirrhosis.