肝硬化MSCT门静脉成像扫描延迟时间的临床研究  

Clinical Study of The Optimal Scan Delay Time in Multislice Spiral CT Portography of Cirrhosis

作　　者：麦栩榆[1] 胡茂清[1] 金志发[1] 李伟[1] 龙晚生[1] 张朝桐[1] 罗学毛[1] 陈文杰[1] 

机构地区：[1]中山大学附属江门医院放射科,广东江门529030

出　　处：《中国现代医生》2010年第16期72-73,75,共3页China Modern Doctor

摘　　要：目的探讨正常人与肝硬化患者MSCT门静脉成像的合理扫描延迟时间。方法对正常组15例、肝硬化代偿组18例、肝硬化失代偿组30例受检者于第一肝门下方的门静脉主干行同层动态扫描,对比剂量1.5mL/kg,注射速率3mL/s,经外周静脉注射对比剂25s后开始扫描,球管旋转时间0.5s/圈,以后间隔2.5s扫描1次,持续至100s。分别测量同一层面门静脉、肝实质的CT值,计算门静脉主干与肝实质密度差(P-L),并绘制时间密度曲线。结果正常组、肝硬化代偿组、肝硬化失代偿组门静脉平均强化峰值和达峰时间分别为205.5HU(49.0s)、186.7HU(51.3s)、169.2HU(62.9s);肝脏平均强化峰值和峰值时间分别为118.8HU(60.4s)、112.4HU(64.8s)、102.4HU(75.4s);门静脉与肝实质密度差分别为87.3HU、74.3HU、67.0HU。统计学分析显示肝硬化失代偿组与正常组、肝硬化代偿组之间的门静脉主干、肝实质峰值及达峰时间比较差异均有统计学意义(P<0.05),正常组与肝硬化代偿组比较除了门静脉主干峰值时间差异无统计学意义(P>0.05),门静脉主干和肝实质峰值差异均有统计学意义(P<0.05)。结论在注射剂量为1.5mL/kg、注射流率为3mL/s时,正常人、肝硬化代偿期患者门静脉成像最佳扫描延迟时间在50s左右,而肝硬化失代偿期患者最佳扫描延迟时间为62s左右。Objective To explore the optimal scan delay time for MSCT portography （MSCTP） in normal individuals and liver cirrhosis patients. Methods 15 normal individuals, 18 patients with compensated hepatic cirrhosis and 30 patients with decompensated hepatic cirrhosis were involved in this study. Single-level dynamic CT scanning were performed at the level of slightly below the first liver hilus,the contrast dose was 1.5ml/kg and injection speed was 3ml/s,starting scan from 25s to lOOs at 2.5s intervals,CT values of the portal vein and liver parenchyma were calculated at identical slice and the time-density curves were drawn. Results The average maximal value of the portal vein and the time for peak enhancement in normal group, compensated group and decompensated group were 205.5HU （49.0s）, 186.7HU （51.3s）, 169.2HU（62.9s）,respectively. And the same measurements of hepatic parenehyma in three group were 118.8HU（60.4s）,112.4HU（64.8s）, 102.4HU（75.4s）,respectively. The average density differences between the portal vein and hepatic parenchyma（P-L） in three group were 87.3HU,74.3HU,67.0HU,respectively. Compare with normal group or compensated group,there were obvious statistical differences in decompensated group for the average maximal value and the time for peak enhancement of the portal vein and hepatic parenchyma（P〈0.05）, there also had obvious statistical differences betwween normal group and conpensated group except the time for peak enhancement of the portal vein （P〉0.05）. Conclusion When contrast dose was 1.5ml/kg and injection speed was 3ml/s in MSCTP,the optimal scan delay time in normal individuals or compensated hepatic cirrhosis patients should he 50s and decompensated hepatic cirrhosis patients should be 62s.

关 键 词：肝硬化 体层摄影术 X线计算机 门静脉成像 延迟时间 

分 类 号：R814.42[医药卫生—影像医学与核医学]