CT灌注成像在经颈静脉肝内门体分流术中的应用  

Application of CT Perfusion Imaging on Transjugular Vein Intrahepatic Portal-Systemic Shunt

作　　者：李家平[1] 陈伟[1] 黄勇慧[1] 王海林[2] 杨建勇[1] 

机构地区：[1]中山大学附属第一医院介入放射科,510080 [2]广州市第一人民医院放射科

出　　处：《临床放射学杂志》2008年第5期680-683,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金(30270417);广东省科技计划项目(2006B36003002)资助项目

摘　　要：目的运用螺旋CT灌注成像评价经颈静脉肝内门体分流(TIPSS)术后肝脏血流灌注的变化。资料与方法对15例行TIPSS治疗的肝硬化门脉高压症患者分别于手术前2天和术后1周行螺旋CT单层肝脏动态增强扫描,比较手术前后肝脏灌注参数的变化。结果TIPSS术前门静脉灌注量(PVP)、肝动脉灌注量(HAP)、总肝灌注量(TLP)和肝动脉灌注指数(HPI)分别为(0.58±0.23)ml.min-1.ml-1、(0.14±0.13)ml.min-1.ml-1、(0.72±0.17)ml.min-1.ml-1和(24.0±10.2)%;TIPSS术后则分别为(0.15±0.04)ml.min-1.ml-1、(0.28±0.05)ml.min-1.ml-1、(0.43±0.07)ml.min-1.ml-1和(64.1±13.9)%;TIPSS术前后肝功能、血氨、门静脉自由压(PFP)等指标组间比较有统计学差异。结论螺旋CT灌注成像能客观评价肝硬化门脉高压症TIPSS术前后肝血流动力学的变化。Objective To evaluate the hepatic perfusion changes before and after transjugular vein intrahepatic portalsystemic shunt （TIPSS）by means of spiral CT perfusion imaging. Materials and Methods CT perfusion imaging was performed in fifteen patients with cirrhosis and portal hypertension 2 days before TIPSS and one week after TIPSS. The hepatic perfusion parameters before and after TIPSS were compared. Results Prior to TIPSS, portal venous perfusion （PVP）, hepatic arterial perfusion （HAP）, total liver perfusion （TLP）, and hepatic arterial perfusion index （HPI） was （0.58±0.23） ml · min^-1 · ml^-1, （0.14±0.13） ml · min^-1· ml^-1,（0.72±0.17） ml · min^-1 · ml^-1, and （24.0± 10.2）%, respectively. After TIPSS, PVP, HAP, TLP, and HPI was （0.15 ·0.04）ml · min^-1· ml-· , （0.28 ±0.05） ml · min^-1 · ml^-1 , （0.43 ±0.07） ml · min^-1 · ml^-1 and （64.1 ± 13.9）%, respectively. There was significant difference in the hepatic function, blood ammonia and portal free pressure between pre-TIPSS and post-TIPSS. Conclusion Spiral CT perfusion imaging could reveal the hemodynamic changes of the liver before and after TIPSS.

关 键 词：体层摄影术 X线计算机 灌注 门静脉高压 门体分流 

分 类 号：R575.2[医药卫生—消化系统]