血吸虫病性肝硬化患者腹部CT表现和CT定量参数特征观察*

目的 探讨血吸虫病性肝硬化患者腹部电子计算机断层扫描(CT)表现和CT定量参数特征。方法 2018年5月～2020年5月我院收治的血吸虫病性肝硬化患者72例,其中Child-Pugh A级26例、Child-Pugh B级21例和Child-Pugh C级25例,另选择同期于我院健康体检者25名。使用飞利浦64排CT行上腹部平扫和增强扫描,选择感兴趣区,获取肝灌注参数血容量(BV)、血流量(BF)、平均通过时间(MTT)、肝动脉分数(HAF)和肝动脉灌注量(HAP)。结果 72例血吸虫病性肝硬化患者出现较典型的肝硬化CT表现、肝功能损伤的血生化学改变和脾功能亢进症表现;健康人腹部CT灌注参数BV、BF、MTT、HAF和HAP分别为(47.3±8.2)ml/100g、(211.9±42.1)ml/min/100g、(12.9±3.1)s、(0.2±0.0)和(16.3±7.9)ml/min/100g,Child-Pugh A级患者分别为(40.8±7.6)ml/100g、(183.1±37.2)ml/min/100g、(15.8±3.7)s、(0.3±0.0)和(19.1±8.8)ml/min/100g,Child-Pugh B级患者分别为(35.5±6.9)ml/100g、(124.7±33.2)ml/min/100g、(19.2±4.5)s、(0.3±0.0)和(24.5±9.9)ml/min/100g,Child-Pugh C级患者分别为(24.8±8.4)ml/100g、(115.5±28.1)ml/min/100g、(24.6±5.5)s、(0.4±0.1)和(33.5±12.5)ml/min/100g,各组间差异显著(P<0.05)。结论 对血吸虫病性肝硬化患者行CT检查能够了解肝脾形态学改变信息,测量CT灌注参数也能够为评估肝硬化的严重程度提供参考依据。

Abdominal CT manifestations and CT quantitative parameters in patients with schistosomiasis cirrhosis

Objective The purpose of this study was to investigate the abdominal computed tomography (CT) manifestations and CT quantitative parameters in patients with schistosomiasis liver cirrhosis (SLC). Methods A total of 72 patients with SLC and 25 healthy volunteers were enrolled in this study between May 2018 and May 2020. The patients with SLC included Child-Pugh class A in 26, Child-Pugh class B in 21, and Child-Pugh class C in 25. All the individuals underwent CT enhanced scan, and the blood volume (BV), blood flow (BF), mean transit time (MTT) , hepatic arterial fraction (HAF) and hepatic artery perfusion (HAP) were recorded. The laboratory indicators, such as total serum bilirubin, albumin, international standardized ratio of prothrombin time, white blood cell counts and platelet counts were detected. Results TheCT examination in 72 patients with SLC showed abnormal ratio of liver lobes, irregular contour and widening of liver fissure, a map-like, diffuse decrease of liver parenchyma density, high density schistosomia-like calcified nodules and portal vein dilatation in liver, portal vein and mesenteric vein, and the blood analysis demonstrated the injured liver function tests and hypersplenism; in healthy subjects,the abdominal CT perfusion parameters, e.g. the BV, BF, MTT, HAF and HAP levels were (47.3±8.2) ml/100g, (211.9±42.1) ml/min/100g, (12.9±3.1) s, (0.2±0.0) and (16.3±7.9) ml/min/100g, respectively, those in patients with SLC of Child-Pugh class A were (40.8±7.6) ml/100g, (183.1±37.2) ml/min/100g, (15.8±3.7) s, (0.3±0.0) and (19.1±8.8) ml/min/100g, in patients with Child-Pugh class B were (35.5±6.9) ml/100g, (124.7±33.2) ml/min/100g, (19.2±4.5) s, (0.3±0.0) and (24.5±9.9) ml/min/100g, and in patients with Child-Pugh class C were (24.8±8.4) ml/100g, (115.5±28.1) ml/min/100g, (24.6±5.5) s, (0.4±0.1) and (33.5±12.5) ml/min/100g, respectively, significantly different among them (P＜0.05). Conclusion The CT examination of liver in patients with SLC could show the morphological changes, and the CT perfusion parameters obtained might help evaluate the severity of liver injuries.