多层螺旋CT肝脏灌注成像在肝硬化血流状态评价中的应用  

The Application of Multi- slice Spiral CT Perfusion Imaging in Evaluation of Cirrhosis Circulation

作　　者：贾晶[1] 李晓军[2] 陈勇[3] 冀鑫[1] 尹姬[3] 朱凯[3] 张伟[3] 赵建国[3] 王爱军[3] 高知玲[3] 

机构地区：[1]宁夏医科大学,银川750004 [2]中国人民解放军第五医院普外科,银川750004 [3]宁夏医科大学总医院放射科,银川750004

出　　处：《宁夏医科大学学报》2013年第12期1362-1365,1371+1441,共6页Journal of Ningxia Medical University

基　　金：国家自然科学基金(61061005)

摘　　要：目的探讨多层螺旋CT肝脏灌注成像在肝硬化血流状态评价中的应用。方法 37例行上腹部CT灌注扫描的肝硬化住院患者,Child-pugh A级15例、Child-pugh B级14例、Child-pugh C级8例;12例因其他疾病(无肝病史)行上腹部灌注增强检查结果为阴性者为对照组。采用GE AW 4.3工作站分别测量HBF、HBV、MTT、HAF、HAP、PVP值,分析比较肝脏灌注参数在正常肝脏与Child-pugh A、B、C级之间差别,以及各级之间的差别。结果肝右叶灌注参数比较,对照组HBF、HBV及PVP值均高于肝硬化各组(P<0.05);MTT值对照组低于Child B、C级(P<0.05);HAF值在Child C级与对照组、Child A、B级之间差异均有统计学意义(P<0.05)。左内叶灌注参数比较,对照组HBF、HBV值高于肝硬化各组(P<0.05),BV值Child A级高于Child C级(P<0.05);HAF值在Child C级高于Child A、B级及对照组(P<0.05)。HAP值对照组高于Child B、C级,且Child A级高于Child C级(P<0.05);PVP值在对照组高于肝硬化各组(P<0.05)。左外叶灌注参数比较,BF值对照组高于Child B、C(P<0.05)。BV值对照组高于肝硬化各组(P<0.05);HAP值及PVP值对照组高于肝硬化各组(P<0.05)。结论多层螺旋CT肝脏灌注成像可有效评价肝硬化血流状态,是肝硬化严重程度及肝脏储备功能的重要影像学指标。Objective To explore the value of clinical application and significance of multi- slice spiral CT Perfusion imaging in evaluation of cirrhosis circulation. Methods 37 cases with cirrhosis were performed multislice CT perfusion enhanced scan of cirrhosis from May 2012 to May 2013. According to the liver function classification standard,the cirrhosis patient were classified into Child A grade 15 cases,Child B grade 14 cases,and Child C grade 8 cases while contrast group 12 cases( the patient didn't have hepatic diseases). The liver perfusion parameters including HBF,HBV,MTT,HAF,HAP,PVP were measured and calculated in GE AW4. 3 work station. The difference of these perfusion parameters between normal liver and cirrhosis liver and the difference in Child A,B,C grade were compared. Results HBF,HBV and PVP of control group was significantly higher than those of cirrhosis groups( P < 0. 05). MTT of Child B,C was significantly higher than those of control group( P < 0. 05). The difference of HAF between Child C and the normal group,Child A,B showed statistically significant( P < 0. 05). Perfusion parameters of left medial lobe such as BF,BV of control group was significantly higher than those of cirrhosis groups( P < 0. 05). BV of Child A was significantly higher than that Child C; HAF of Child C was significantly higher than that of Child A,B and control group( P <0.05).HAPofcontrolgroupwashighersignificantlythanthatofChildB,CandChildA ( P <0. 05). PVP of control group was significantly higher than that of cirrhosis groups( P <0. 05). Perfusion parameters of left lateral lobe such as HBF of control group was significantly higher than that of Child B,C( P < 0. 05),HBV of control group was significantly higher than that of cirrhosis groups( P <0. 05). HAP and PVP of control group was significantly higher than those of cirrhosis groups( P < 0. 05).Conclusion Multislice CT liver perfusion imaging can evaluate the hepatic circulation and it is an important imageology index in severe of cirrhosis and liver reserving function.

关 键 词：体层摄影技术 X线计算机 肝硬化 肝脏灌注成像 

分 类 号：R575.2[医药卫生—消化系统]