肝硬化患者64层螺旋CT血流灌注参数与MELD评分系统相关性研究  

Investigation of Correlation Between Hepatic Perfusion Parameters with Dynamic Enhanced CT Scans and the Model for End-stage Liver Disease Scores in Patients with Liver Cirrhosis

作　　者：王芳军[1] 陈卫昌[1] 郭亮[2] 方向明[2] 张同华[2] 

机构地区：[1]苏州大学附属第一医院消化科内科,215006 [2]苏州大学附属第一医院影像科

出　　处：《临床放射学杂志》2008年第3期331-334,共4页Journal of Clinical Radiology

摘　　要：目的采用64层螺旋CT动态成像测定肝脏血流量,研究肝硬化患者血流灌注参数变化与终末期肝病模型(MELD)评分与肝脏血流量动态变化的关系。资料与方法64层螺旋CT肝血流灌注成像41例,其中肝硬化31例,健康志愿者及其他疾病行腹部CT检查者10例,计算肝脏血流灌注各参数。结果对照组肝门静脉灌注量PVP为(73.07±8.53)ml·100ml-1·min-1,肝动脉灌注量ALP为(11.25±1.70)ml·100ml-1·min-1,肝动脉灌注指数HPI为(13.59±2.27)%。肝硬化时,门静脉灌注量PVP为(46.53±15.70ml/100ml/min),肝动脉灌注量ALP为(16.21±5.50)ml·100ml-1·min-1,肝动脉灌注指数HPI为(27.87±13.25)%。两组间灌注参数差异均存在显著性意义(P<0.05)。MELD评分>6分患者肝血流灌注与MELD评分?6分间差异存在显著性意义(P<0.05)。MELD评分<6分与对照组间ALP、HPI差异无统计学意义(P>0.05)。灌注参数PVP、HPI与MELD分级高度相关(γ>0.75)。结论肝脏CT灌注成像可定量测定肝脏血流量参数,灌注参数与MELD分级相关。肝硬化时CT血流灌注可用于评估疾病的严重程度。Objective To study association between hepatic perfusion parameters measured with dynamic enhanced CT scans and the model for end-stage liver disease （MELD） scores in patients with liver cirrhosis. Methods Dynamic enhanced CT scans of the liver were performed in 41 subjects including 10 subjects as control and 31 patients with liver cirrhosis with 64-slice CT scanner. A correlation analysis between perfusion parameters measured with dynamic enhanced CT scans and MELD scores was completed. Results In the control group, arterial liver perfusion （ALP）, portal venous perfusion（PVP）and hepatic perfusion index （HPI） was （73.07 ±8.53） ml^-1·min^-1, （ 11.25 ± 1.70）ml^-1·min^-1,and （ 13.59 ± 2.27） %, respectively. ALP, PVP, HPI in patients with liver cirrhosis was （ 16.21±5.50）ml^-1·min^-1 , （46.53 ± 15.70） ml· 100 ml^-1·min^-1 , （27.87 ± 13.25） %, respectively. In patients with liver cirrhosis, PVP decreased （P 〈 0.05）, but ALP and HPI increased （P 〈 0.05）. PVP in patients with MELD scores 〉 6 was lower than that in patients with MELD scores 〈6（ P 〈 0.05）. There was no significant difference in ALP and HPI between patients with MELD scores 〈 6 and subjects as control. A significant correlation was seen between these three perfusion parameters and MELD scores. Conclusions Hepatic perfusion parameters could be measured with dynamic enhanced CT scans. There was correlation between perfusion parameters and MELD scores.

关 键 词：肝硬化 体层摄影术 X线计算机 MELD评分 

分 类 号：R575.2[医药卫生—消化系统] R816.5[医药卫生—内科学]