肝炎后肝硬化的CT灌注功能变化研究  

Study on perfusion changes of the hepatic parenchyma during the transformation from normal liver to viral-induced cirrhosis

作　　者：钟群[1,2] 方心华[3] 陈自谦[1,2] 赵春雷[1,2] 钱根年[1,2] 张雪林[4] 

机构地区：[1]厦门大学福州总院临床医学院 [2]南京军区福州总医院医学影像中心,福建福州350025 [3]解放军184医院放射科,江西鹰潭335400 [4]南方医科大学附属第一医院医学影像中心,广东广州510515

出　　处：《医学影像学杂志》2010年第6期840-844,共5页Journal of Medical Imaging

基　　金：福建省青年人才创新项目(编号:2006F3105)

摘　　要：目的:研究肝炎后肝硬化形成中的CT灌注变化规律。方法:120例分为正常对照组34例,肝炎肝纤维化组21例,肝炎后肝硬化组65例(Child-Pugh A组27例,Child-Pugh B组23例,Child-Pugh C组15例)经16层CT扫描得到肝脏实质各期的灌注指标:血流量(blood flow,BF)、血容量(blood volume,BV)、平均通过时间(mean transit time,MTT)、毛细血管表面通透性(permeability surface area product,PS)、肝动脉灌注分数(hepatic arterial fraction,HAF)、到达时间(IRF time of arrival,IRFTO),诸指标分别采用单析因方差分析(one-way ANOVA)评价各时期肝脏灌注指标差异性,P<0.05被认为有显著性差异。结果:5组肝脏实质BF、BV、MTT、PS、HAF均有统计学意义。随着病程进展,BF、BV逐步下降,MTT、PS、HAF逐渐上升,但在部分阶段改变不明显。结论:在肝炎后肝硬化的形成发展过程中,肝脏实质的灌注指标具有一定的变化规律。Objective：The aim was to explore perfusion changes of the hepatic parenchyma during the transformation from normal liver to viral-induced cirrhosis.Methods：One hundred and twenty cases were sorted into 5 groups： 34 cases as normal controls,21 cases with viral-induced fibrosis;27 cases of viral-induced cirrhosis with Child-Pugh A,23 cases of viral-induced cirrhosis with Child-Pugh B,and 15 cases of viral-induced cirrhosis with Child-Pugh C.With perfusion model and software of 16 multi-slices CT,the perfusion parameters,including blood flow（BF）,blood volume（BV）,mean transit time（MTT）,permeability surface area product（PS）,hepatic arterial fraction（HAF）,IRF time of arrival（IRF TO） of hepatic parenchyma were obtained.One-way ANOVA was applied to analyze each parameter value of the 5 groups,the statistical significance was defined as a P value less than 0.05.Results：Significant difference of BV,BV,MTT,PS,and HAF were observed among 5 groups（P〈0.05,respectively）.Along with the disease aggravation,BF values,BV values were gradually decreased,and meanwhile MTT values,PS values,HAF values gradually increased.But,there was some subtle change in some periods.Conclusion：CT perfusion imaging can reflect hemodynamic changes during the process of transformation from normal liver to viral-induced cirrhosis.

关 键 词：肝硬化 体层摄影术 X线计算机 灌注 

分 类 号：R575.2[医药卫生—消化系统] R814.42[医药卫生—内科学]