分段注射对比剂CT增强扫描提高乙型肝炎肝硬化患者肝静脉显影效果研究*

目的 研究分段注射对比剂CT造影对乙型肝炎肝硬化患者肝静脉显影效果的影响。方法 2018年3月～2020年9月我院诊治的乙型肝炎肝硬化患者62例,在CT增加造影检查时,分为观察组32例,采取分段注射对比剂,和对照组30例,常规注射对比剂碘伏醇。记录肝动脉灌注量(HAP)、门静脉灌注量(HPP)、肝动脉灌注指数(HPI)和动脉灌注分数(APF)。结果 在32例观察组中,CTA显影图像质量显著优于对照组(P<0.05);观察组与对照组肝静脉CT值【(138.6±13.4)HU 对(125.5±11.8)HU】、门静脉主干CT值【(218.8±41.3)HU对(176.9±35.8)HU】、门静脉右支CT值【(204.6±31.5)HU对(163.3±28.7)HU】和门静脉左支CT值【(198.5±21.9)HU 对(154.0±23.2)HU】比较,差异均有统计学意义(P<0.05);观察组与对照组对比剂门静脉峰值时间【(17.5±2.2)HU 对(19.7±3.0)HU】和肝实质峰值时间【(35.7±3.8)HU对(40.1±4.3)HU】比较,差异均有统计学意义(P<0.05);两组HAP【(16.3±4.8)ml/min/100ml 对 (15.8±5.2)ml/min/100ml】、HPP【(18.9±5.7)ml/min/100ml对(17.5±6.4)ml/min/100ml】、HPI【(40.6±10.1)% 对(42.2±9.6)%】和APF【(31.2±8.3)%对(30.9±7.5)%】比较,差异均无统计学意义(P>0.05)。结论 采取分段注射对比剂行CTA造影检查有助于提高乙型肝炎肝硬化患者腹部CT检查的图像质量,尤其是能提高肝静脉显影效果,有助于指导临床诊治。

Impact of segmented injection of contrast agent on hepatic vein imaging by CT angiography in patients with hepatitis B cirrhosis

Objective The aim of this study was to investigate the impact of segmented injection of contrast agent, ioversol, on hepatic vein imaging by CT angiography (CTA) in patients with hepatitis B-induced liver cirrhosis (LC). Methods 62 patients with hepatitis B cirrhosis were enrolled in our hospital between March 2018 and September 2020, and were divided into observation (n=32) and control group (n=30) when CTA was underwent, with segmented injection or conventional injection of contrast medium, respectivley. The hepatic artery perfusion (HAP), hepatic portal perfusion (HPP), hepatic perfusion index (HPI) and arterial perfusion fraction (APF) were recorded. Results The imaging quality in observation was much more superior to that in the control (P<0.05); the CT value of hepatic vein [(138.6±13.4)HU vs. (125.5±11.8 )HU], of main portal vein[(218.8±41.3)HU vs. (176.9±35.8)HU],of right branch of portal vein[(204.6±31.5)HU vs. (163.3±28.7)HU] and of left branch of portal vein [(198.5±21.9)HU vs. (154.0±23.2)HU]were statistically significantly different between the two groups (P<0.05); the peak contrast media time of portal vein [(17.5±2.2)HU vs. (19.7±3.0)HU] and the peak time of liver parenchyma [(35.7±3.8)HU vs. (40.1±4.3)HU]were statistically significantly different between observation and control group (P<0.05); the HAP[(16.3±4.8) ml/min/100ml vs. (15.8±5.2) ml/min/100ml], HPP [(18.9±5.7)ml/min/100ml vs. (17.5±6.4)ml/min/100ml], HPI[(40.6±10.1)% vs. (42.2±9.6)%]and APF [(31.2±8.3)% vs. (30.9±7.5)%] in the two groups were not statistically significantly different (P>0.05). Conclusion The segmented injection of contrast medium is superior to conventional injection when CTA is done, which might give us a high-quality imaging and help us make an appropriate diagnosis.