多层螺旋CT肝脏灌注测量在肝硬化中的初步应用  

Preliminary Application of CT Hepatic Perfusion with Multi-slice spiral CT in Cirrhosis

作　　者：史丽静[1] 田建明[1] 李晓兵[2] 李树平[1] 陈炜[1] 左长京[1] 王敏杰[1] 

机构地区：[1]第二军医大学附属长海医院放射科,上海200433 [2]苏州市第二人民医院放射科,215002

出　　处：《临床放射学杂志》2005年第6期515-518,共4页Journal of Clinical Radiology

摘　　要：目的探讨多层螺旋CT肝脏灌注测量在肝硬化中的应用价值。资料与方法37例接受多层螺旋CT肝脏灌注测量。20例无明显肝脏疾患的志愿者(正常组),17例肝硬化患者(肝硬化组),再按其肝硬化程度分为两组:9例为轻中度肝硬化(轻中度肝硬化组),8例为重度失代偿肝硬化(重度失代偿组)。计算各例的各项灌流指标并进行组间比较。结果(1)肝硬化组与正常组相比,门静脉灌流量(HPP)、门静脉灌流指数(PPI)明显减低[HPP:(0.49±0.19)ml·min-1·ml-1与(0.60±0.16)ml·min-1·ml-1,P=0.045;PPI:0.58±0.14与0.67±0.06,P=0.015],门静脉与肝动脉灌流比率(HPP/HAP)亦明显减低(1.63±0.87与2.12±0.65,P=0.04),肝动脉灌注指数(HPI)升高(0.42±0.14与0.33±0.06,P=0.015),提示肝硬化时HPP减少,门静脉血流在肝脏血供中的比例减少,而动脉的灌流比重增加;(2)重度失代偿组肝硬化HAP较轻中度组明显升高[分别为(0.48±0.16)ml·min-1·ml-1与(0.25±0.07)ml·min-1·ml-1,P=0.002],HPI亦明显升高(分别为0.54±0.10与0.32±0.07,P=0.0001),PPI则明显降低(分别为0.46±0.10与0.68±0.07,P=0.0001),提示不同程度肝硬化其灌注指标存在差异,灌注改变与肝硬化程度有关。结论肝脏CT灌注测量可以反映肝硬化的血流灌注改变,灌注值的变化也能够提示肝硬化的程度。Objective To discuss the value of hepatic perfusion with multi-slice spiral CT in cirrhosis.Materials and Methods 37 patients were underwent with dynamic CT of the liver. 20 were volunteers without hepatic disorder, other 17 cases with cirhosis were devided into 2 groups according to the degree of their cirrhosis: 9 cases were slight-to-middle degree, other 8 cases were severe degree. Parameters of CT perfusion were measured and compared with each group.Results (1)Compared to the control group, HPP, PPI and HPP/HAP of patients with cirrhosis were significant lower [HPP: (0.49±0.19)ml·min -1·ml -1 vs (0.60±0.16)ml·min -1·ml -1, P=0.045; PPI: 0.58±0.14 vs 0.67±0.06, P=0.015]; HPP/HAP: 1.63±0.87 vs 2.12±0.65, P=0.04, whereas HPI was significant higher (0.42±0.14 vs 0.33±0.06, P=0.015), indicated the decrease of portal inflow and the increase of arterial inflow in cirrhosis. (2)Patients with severe cirrhosis got higher HAP than patient with slight-to-middle degree (0.48±0.16)ml·min -1·ml -1 vs (0.25±0.07)ml·min -1·ml -1, P=0.002), their HPI were also higher (0.45± 0.10 vs 0.32±0.07, P=0.0001), whereas their PPI were significant lower (0.46±0.10 vs 0.68±0.07, P=0.0001), indicated the changes of hepatic perfusion were correlated with the degree of cirrhosis. Conclusion Hepatic perfusion with multi-slice spiral CT could reflect the change of blood flow of liver cirrhosis, and also indicate the different degree of cirrhosis.

关 键 词：多层螺旋CT 肝脏灌注 测量 初步应用 度肝硬化 失代偿肝硬化 肝硬化患者 肝动脉灌注 门静脉血流 应用价值 肝脏疾患 灌流指数 肝脏血供 灌注指标 血流灌注 CT灌注 正常组 PPI 志愿者 重度 灌流量 升高 HPP 轻中度 HAP HPI 

分 类 号：R816.5[医药卫生—放射医学]