CT灌注成像评估活体肝移植术后肝脏血液动力学变化  

Computed Tomography Perfusion Technique in Living Donor Liver Transplantation:an Initial Study of Hemodynamic Changes in Liver Grafts

作　　者：秦玲娣[1] 庄治国[1] 钱黎俊[1] 汪笔雄[1] 王文晶[1] 周滟[1] 夏强[2] 许建荣[1] 

机构地区：[1]交通大学医学院附属仁济医院放射科,上海200127 [2]交通大学医学院附属仁济医院肝移植科,上海200127

出　　处：《放射学实践》2009年第11期1214-1218,共5页Radiologic Practice

基　　金：国家自然科学基金项目资助(30770608);上海交通大学医学院重点学科项目资助;上海市重点学科建设项目资助(S30203)

摘　　要：目的:探讨CT灌注成像技术在评估活体肝移植术后肝脏血液动力学变化中的临床应用价值。方法:35例右叶活体肝移植供体,30例右叶活体肝移植术后无SFSS受体及6例伴SFSS受体患者均行肝脏CT灌注成像,测量各组活体肝移植术前供体及术后14天和28天受体肝总血流量(TBF)、肝动脉灌注量(HAP)及门静脉灌注量(PVP)。分析和各组之间灌注参数的差异及相关性。结果:与正常供体捐赠前[(PVP0=(82.5±13.0)ml/(min.100g)]相比,无SFSS受体的患者在术后14天和28天时PVP明显增高[PVP14=(139.7±40)ml/(min.100g),PVP28=(109.8±19)ml/(min.100g)],差异有极显著性意义(P<0.001和P=0.008),但术后28天PVP较术后14天明显降低(P=0.007)。SFSS组术后14天PVP较无SFSS组明显增高[PVP14=(186.0±22.0)ml/(min.100g)],差异有显著性意义(P=0.042)。结论:CT灌注成像能准确评价无SFSS供体血流动力学改变。Objective：To explore the clinical value of CT perfusion technique in evaluating the bemodynamic changes in grafts of living donor liver transplantation （LDLT）. Methods：35 donors of right lobe LDLT, 30 recipients without small for size syndrome （SFSS） and 6 recipients with SFSS after LDLT underwent CT perfusion examinations. Total blood flow （TBF）,hepatic arterial perfusion （HAP） and portal vein perfusion （PVP） in donors before donation and recipients on post- operation day （POD） 14 or 28 were measured. The differences and correlation of perfusion parameters between various groups were analyzed. Results：Compared with the normal donor before donation [PVP0 （82.5±13.0）ml/（min·100g）], PVP was higher in recipients without SFSS on POD 14 or 28[PVP14= （139.7±40. 0）ml （min·100g） ,PVP28 （109.8± 19.0）ml/（min·100g）], with significant differences （P〈0. 001 and P=0. 008,respeclively）, yet PVP on POD 28 was significantly decreased compared with that on POD 14 （P= 0. 007）. PVP in the recipients with SFSS was significantly greater than that without SFSS on POD14 [PVP14 （186.0±22.0）ml/（min · 100g）] ,with significant statistical difference （P±0. 042）. Conclusion： Hemodynamic changes in grafts without SFSS could be accurately evaluated by CT perfusion examination.

关 键 词：体层摄影术 X线计算机 灌注成像 肝移植 血流动力学 

分 类 号：R657.3[医药卫生—外科学] R816.5[医药卫生—临床医学]