正常肝脏血流分布的CT灌注成像研究  

A study of CT perfusion imaging in blood distribution of normal liver

作　　者：李敏达[1] 顾红梅[1] 周国锋[1] 吴娟[1] 曹亮[1] 陈峰[1] 沈海霞[1] 

机构地区：[1]南通大学附属医院影像科,江苏南通226001

出　　处：《实用放射学杂志》2013年第8期1266-1268,1273,共4页Journal of Practical Radiology

摘　　要：目的通过研究正常肝脏CT灌注成像表现，了解其血流动力学特点。方法对21例正常肝脏患者进行CT灌注成像，感兴趣区（region of interest，R01）放黄于肝左内叶、左外叶、右前叶及右后叶4个点。观察肝脏灌注彩图、灌注参数及时间-密度曲线（time density curve，TDC）特点。结果正常肝脏肝动脉灌注量（hepatic arterial perfusion，HAP）图呈均匀中等度灌注，门静脉灌注量（hepatic portal perfusion，HPP）图呈明显不均匀高灌注。正常肝实质TDC特征为动脉期上升缓慢，门静脉期上升较快并达峰值。正常肝脏左外叶与左内叶、右前叶与右后叶比较，各参数值间差异均无统计学意义。肝左叶HAP、肝动脉灌注指数（hepatic pefusion index，HPI）高于右叶，而HPP低于有叶，差异均有统计学意义，左右半肝之间总肝灌注量（total liver perfusion，TI．P）差异无统计学意义。结论CT灌注成像能更好地反映正常肝脏的血流动力学特点；左、右2叶间血流分配比例有差别，因此进行肝脏病变血流动力学研究时，应尽量选择病灶侧肝叶作为对照。Objective To understand the hemodynamic characteristic of normal livers through the study of their performance in CT perfusion imaging. Methods 21 normal livers underwent CT perfusion imaging. Four ROIs were placed respectively in left inner segment, left outer segment, right anterior segment and right posterior segment. Characteristics of coloured perfusion images, per fusion parameters and time-density curve（TDC） were analyzed. Results Normal livers showed middle extent perfusion at hepatic arterial perfusion（HAP） image, and high perfusion at hepatic portal perfusion（ HPP） image. The TDC of normal hepatic parenchyma rose slowly in arterial phase, whereas it rose fast and achieved the peak in portal vein phase. In normal livers, the HAP and HPI values of left hepatic lobe were higher than those of right hepatic lobe,while the HPP value of left lobe was lower. And the differences were statistically significant. There was no significant difference of the TLP value between two lobes. Conclusion The hemodynamic characteristic of normal livers can be better reflected by using CT perfusion imaging. There is some difference in blood distribution between the left and right lobe of normal livers. Therefore, when studying hemodynamic characteristics of hepatic lesions,we should try to select the same lobe with the lesion as contrast.

关 键 词：肝脏 血流分布 计算机体层成像 灌注成像 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]