CT灌注成像对急性胰腺炎患者肾脏血流动力学的研究

目的应用多层螺旋CT（MSCT）灌注成像技术测量和评价急性胰腺炎患者的肾脏血流灌注情况，探讨急性胰隙炎肾脏血流变化的特点。方法对24例正常对照组和59例急性胰隙炎病例组，其中轻症胰腺炎21例，重症胰腺炎38例，行64排128层螺旋cT肾脏灌注检查。在工作站上使用perrusion 4软件包对数据进行处理，得出感兴趣区的灌注参数值，包括血流量（blood flow，BF），血容量（blow volume，BV），对比剂平均通过时间（mean transit time，MTT）和表面渗透积乘积（permeability suface area product,PS）。采用SPSS13．0软件包进行统计分析。结摹MAP、SAP较正常对照组肾皮质BF值明显减低，MTT值明显延长[肾皮质BF对照组（345．74±106．69）ml.100g-1·mn-1，MAP组（261．56±49．96）ml·100g-1.min-1，SAP组（229．28±29．51）ml．100g-1·min-1;P〈0．05。MTT：对照组（7．89±4．69）s．MAP组（10．19±1．99）s，SAP组（12．67±4．23）S，P〈0．05]，SAP较正常对照纽肾皮质Ps值明显减低[对照组（69．08±38．87）ml．100g-1.min-1，SAP组（52．82±25．59）ml．100g-1.min-1;P〈0，05];3组间的肾髓质参数及肾皮质BV值差别无统计学意义（P〉0．05）。结论急性胰腺炎导致肾脏皮质BF值明显减少，MTT明显延长，肾髓质各参数及肾皮质Bv值无明显变化。

The Renal Perfusion Change in Acute Pan- creatitis Assessed by CT

Objective To study the changes of renal perfusion parameters with acute pan- creatitis by CT pel-fusion. Methods Dynamic contrast-enhanced single-location sequences CT scans of the renal were obtained in 59 individuals who included 24control subjects, 21 patients with mild acute pancreatitis（MAP） and 38 patients with severe acute pancreatitis （SAP） proven by clinical. These data were processed on GE AW 4.4 workstation using renal peffusion agreement of perfusion 4 software package. Renal perfusion parameters such as renal blood flow（BF）, blood volume（BV）, mean transit time（MTT）, permeability surface area product（PS） were calculated. Statistics treatment made SPSS 13.0 software. Results Compared with control group, he renal cortical BF of MAP group and SAP group were significantly reduced, the renal cortical MTT were significantly prolonged[ cortex BF： （345.74 ± 106.69）ml. 100g-1. min-1 in control group, （261.56 ± 49.96）ml - 100g-1.min- in MAP group, （229.28 ± 29.51）ml - 100g-1 . min-1 in SAP group; P〈0.05. Cortex MTT： （7.89 ±4.69）s in control group, （10.19 ±1.99）s in MAP group, （12.67 ± 4.23）s in SAP group, P〈0.05]. Compared with control group,the renal cortical PS of SAP group were significantly decreased[（69.08 ± 38.87）ml .100g-1 in-lin control group, （52.82 ± 25.59）ml - 100g-1.min-1in SAP group,P〈0.05]. Renal medulla parameters and renal cortical BV values of three group had not significant difference（P〉0.05）. Conclusion In AP BF of cortex renal were decreased obviously, and MTT was significant increased, but BV of cortex renal and the parameters of medulla renal had not obviously change.