肝硬化脾血流量变化的CT灌注成像初步研究  

CT evaluation of splenic perfusion in liver cirrhosis

作　　者：江利[1] 杨建勇[1] 杨旭峰[1] 谢洪波[1] 严超贵[1] 李子平[1] 

机构地区：[1]中山大学附属第一医院医学影像科,广州510080

出　　处：《影像诊断与介入放射学》2010年第4期212-213,共2页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金资助项目(编号:30270417)

摘　　要：目的通过检测单位体积的脾灌注量,观察肝硬化时脾脏血流量的变化及其与门静脉灌注量的关系。方法 19例经临床及实验室、B超检查诊断为肝硬化的患者,其中Child A级患者8例,Child B级患者7例,Child C级患者4例。对照组为13例无肝脏疾病的患者。所有患者均选取同时含有肝脏、脾脏、主动脉和门静脉的层面行单层CT动态增强扫描,绘制ROI时间-密度曲线计算脾脏灌注量和肝脏门脉血流量。结果正常组脾脏灌注量为1.1542±0.1408ml(min·ml),肝硬化组脾脏灌注量为1.0172±0.3137ml(min·ml),其中Child A级肝硬化组脾脏灌注量为1.2272±0.2574ml(min·ml),Child B级肝硬化组脾脏灌注量为1.0016±0.4450ml(min·ml),Child C级肝硬化组脾脏灌注量为0.6240±0.0672ml(min·ml)。严重肝硬化患者脾脏血流灌注量明显下降。门静脉灌注量和脾脏灌注量呈正相关(r=0.3023,P=0.02,y=0.3998x+0.4256)。结论螺旋CT灌注成像CT可定量测量脾脏血流量参数,肝硬化时脾脏灌注量的测定有助于反映肝硬化时门静脉灌注的变化。Objective To estimate splenic perfusion with helical CT and to study the relationship between splenic perfusion and portal vein perfusion in liver cirrhosis. Methods Dynamic single-section computed tomography （CT） of liver and spleen was performed on 32 subjects, including 19 patients with liver cirrhosis and 13 patients without liver disease as control. CT scans were obtained at a single level to in- clude the liver, spleen, aorta and portal vein. On each CT scan, the attenuation of these organs was measured in regions of interest to provide time-density curves. The splenic perfusion and portal vein perfusion of the liver were assessed. Results Splenic perfusion was 1.1542±0. 1408 mL/min/mL in comrol subjects and 1.0172±0.3137 mL/min/mL in patients with liver cirrhosis （ 1.2272±0.2574 mL/min/mL in Child A cirrhotic patients, 1.0016±0.4450 mL/min/mL in Child B cirrhotic patients, 0.6240±0.0672 mL/min/mL in Child C cirrhotic patients）. Portal vein perfusion of the liver was positively correlated to the splenic perfusion （r=0.3023, P=0.02, y = 0.3998x ＋ 0.4256）. Conelusion Dynamic single-section CT shows potential in quantifying splenic perfusion. Splenic perfusion reflects portal vein perfusion in liver cirrhosis.

关 键 词：体层摄影术 X线计算机 灌注成像 脾脏灌注 肝硬化 

分 类 号：R816.5[医药卫生—放射医学]