MSCT双期扫描对评价肝硬化患者肾脏血流动力学的可行性  

Feasibility of dual-phasic contrast-enhanced MSCT scans in evaluating the renal hemodynamics of cirrhosis patients

作　　者：蒙秋华 曾庆思 伍筱梅 李新春 谭理连 韩铭钧[3] 

机构地区：[1]广州市医学院第一附属医院放射科,广东广州510120 [2]广州市医学院第二附属医院放射科 [3]中山大学第五附属医院放射科

出　　处：《实用医学影像杂志》2011年第3期182-184,190,共4页Journal of Practical Medical Imaging

摘　　要：目的研究MSCT双期扫描中CT强化值(HU)测量对评价肝硬化患者肾脏血流动力学的可行性。方法对47例经临床资料、B超证实的肝硬化,其中肝功能Child-Pugh分级A级16例,B级23例,C级8例以及36例非肝硬化患者作为对照组均经MSCT双期扫描并测量左肾皮质及髓质的动脉期、门脉期的CT强化值。结果肝硬化组左肾皮质、髓质的动脉期、门脉期的CT强化值均有所下降,其中左肾皮质动脉期、门脉期的CT强化值与对照组间的差异具有统计学意义(P<0.05),随着肝硬化程度的加重,左肾皮质的动脉期、门脉期CT强化值呈递减趋势,经方差分析,左肾皮质的动脉期、门脉期的CT强化值在肝硬化组Child A、Child B和Child C组间的差异有统计学意义(P值均<0.05),而左肾髓质的动脉期、门脉期的CT强化值在对照组、肝硬化组Child A、Child B和Child C组间的差异均无统计学意义(P值均>0.05)。结论肝硬化时左肾皮质的动脉期、门脉期CT强化值下降,下降程度与肝硬化的严重程度呈正相关,MSCT双期扫描能评价肝硬化患者肾脏的血流动力学状况。Objective To study the feasibility of CT value（Hounsfield Unit,HU） measurements during dual-phasic contrast-enhanced CT scans in evaluating the renal hemodynamics of cirrhosis patients.Methods Forty-seven patients with cirrhosis confirmed by clinical data and ultrasonography as observation subjects and 36 non-cirrhosis patients as control group underwent dual-phasic contrast-enhanced 16-slice spiral CT（MSCT） scans and subsequent CT value measurements during the arterial phase and portal venous phase.The cirrhosis patients were divided into following three subgroups according to their liver functions： Child-Pugh A（n=16）,Child-Pugh B（n=23） and Child-Pugh C（n=8）.The enhanced CT values of the left renal cortex and medullary of each group patients during the arterial phase and portal venous phase were separately measured and calculated.Results Compared with control group,the enhanced CT values of the left renal cortex and medullary in cirrhosis patients during the arterial phase and portal venous phase were significantly decreased（P 0.05）.The decreasing level of CT values in cirrhosis patients was positively correlated with the severity of cirrhosis.Using chi-square test demonstrated that,there also were statistical difference between Child-Pugh A,Child-Pugh B and Child-Pugh C of cirrhosis in enhanced CT values of the left renal cortex during the arterial phase and portal venous phase（P 0.05） but there were no statistical difference between adove three subgroups or cirrhosis and control group in those of left renal medullary during the arterial phase and portal venous phase（P 0.05）.Conclusion The enhanced CT values（HU） of the left renal cortex in cirrhosis patients during the arterial phase and portal venous phase were decreased and the decreasing level was positively correlated to the severity of cirrhosis,and thus dual-phasic contrast-enhanced MSCT scans are able to evaluate the renal hemodynamics of cirrhosis patients.

关 键 词：肝硬化 肾脏血流动力学 CT值 CHILD-PUGH分级 双期CT扫描 

分 类 号：R575.2[医药卫生—消化系统]