应用256层螺旋CT灌注技术研究兔肝I/R后血流动力学变化  

Evaluation of the hemodynamic changes of rabbit liver ischemia reperfusion injury by 256-slice spiral CT perfusion imaging

作　　者：郭成伟[1,2] 沈三弟[2] 易贤林[2] 张忠林[1] 吴爱兵[2] 梁长虹[1] 

机构地区：[1]广东省医学科学院广东省人民医院放射科,广东广州510080 [2]南方医科大学研究生学院,广东广州510515

出　　处：《中国普通外科杂志》2011年第1期67-70,共4页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(308002693097098);广东省科技计划基金资助项目(2005B10401040);广东省自然科学基金资助项目(5001199)

摘　　要：目的应用256层螺旋CT灌注成像分析兔部分肝脏缺血再灌注损伤(I/R)后阶段血流动力学的变化规律及其价值。方法新西兰大白兔阻断肝左叶血供60min后,恢复血供,按缺血再灌注的时间分为6,12,24 h和假手术(S)组,每组6只。各组分别采用256层螺旋CT行全肝灌注成像和病理学分析。在灌注图上测量肝动脉灌注量(HAP),门静脉灌注量(HPP),总灌注量(TLP)以及肝动脉灌注指数(HPI)。结果 (1)在I/R 6,12,24 h组肝脏血流出现差异性分布(低灌注的肝组织,即梗死区)。(2)在梗死的肝组织中,与S组相比,I/R 6 h组中HPP,TLP外,I/R12 h和24 h组HAP,HPP,TLP均低于对照组,而HPI则高于对照组.在灌注相对正常的肝组织中各灌注参数均呈下降趋势。(3)I/R组梗死与未梗死肝组织CT灌注参数之间差异有显著性。结论 CT灌注参数能够客观准确地反映肝I/R病理过程中血流动力学的变化。[中国普通外科杂志,2011,20(1):67-70]Objective To evaluate the value of CT perfusion imaging（CTP） for assessment of liver ischemia reperfusion injury（I/R） in a rabbit model using 256-slice spiral CT.Methods Rabbits underwent 60 min of left lobar ischemia and then were divided into 6,12 and 24 h of reperfusion groups,and one sham operation group（n=6,for each group）.All the rabbits were imaged with a CT perfusion protocol.The perfusion indices of hepatic arterial perfusion（HAP）,hepatic portal perfusion（HPP）,total liver perfusion（TLP） and hepatic perfusion index（HPI） were measured after obtaining perfusion index maps on workstation.Liver samples underwent histological examination after every group had completed scan workuop.Results（1） Heterogeneity of hepatic microvascular flow patterns appeared in the I/R 6,12 and 24 h groups（low perfusion area or infarcted regions）.（2） In infarcted regions of I/R groups,the HPP,TLP and HAP were lower than those of sham group except the HAP in I/R 6 h group,but HPI was higher compared to sham group.The perfusion parameters in the non-infarction area were declined.（3）There were significant differences in CT perfusion parameters between infarction and non-infarction area.Conclusions CTP can objectively and quantitatively reflect the alterations of liver hemodynamics in I/R injury.

关 键 词：再灌注损伤 灌注成像 体层摄影术 螺旋计算机 肝/血液供给 

分 类 号：R321.5[医药卫生—人体解剖和组织胚胎学]