肝硬化上腹部多器官CT灌注表现初探  

CT Perfusion Imaging of the Upper Abdomen organs in Cirrhotic Patients

作　　者：李芃[1] 赵建农[2] 韩福刚[1] 唐光才[1] 舒健[1] 

机构地区：[1]泸州医学院附属医院放射科,四川646000 [2]重庆医科大学附属第二医院放射科,重庆400010

出　　处：《临床放射学杂志》2014年第1期50-54,共5页Journal of Clinical Radiology

摘　　要：目的探讨全肝各叶、胰腺各部位CT灌注血流特征及肝硬化时肝脏血流量的变化情况及其对周围上腹部实质脏器灌注的影响。方法采用320排容积CT对45例肝硬化组及45名正常对照组进行上腹部容积灌注扫描,通过Body perfusion软件后处理得到不同肝叶的肝动脉灌注量(HAP)、门静脉灌注量(HPP)、动脉灌注分数(APF)、胰腺不同部位及脾的动脉灌注量(AP)并进行统计学分析。结果正常对照组肝左外叶HAP、APF高于肝右前叶、右后叶(P分别为0.006、0.012、0.002、0.004),HPP低于肝右前叶、右后叶、左内叶,差异均有统计学意义(P分别为0.012、0.007、0.03)。肝硬化组HAP、HPP、APF在各肝叶间均未表现出明显的统计学差异(P>0.05)。肝硬化不同Child-Pugh分级组和对照组之间HAP、HPP、APF差异有统计学意义(H=46.12,31.71,61.37;P=0.000)。正常对照组胰头、胰体、胰尾部AP无明显统计学差异(P>0.05)。肝硬化组胰体、胰尾部的AP低于胰头部(P=0.000)。肝硬化组胰腺各部位、脾的AP低于对照组(t分别为4.836、8.467、8.548、7.854,P<0.01)。结论正常人各肝叶灌注情况不尽相同,正常胰腺各部位灌注均匀,肝硬化时肝内灌注差异消失,胰腺、脾的灌注降低。Objective To investigate the CT perfusion blood flow characteristics of the whole liver, pancreas and liver blood flow changes of cirrhosis and its impact on perfusion of the surrounding parenchymal organs. Methods 320 slice Volume CT was used in 45 cases of liver cirrhosis and 45 healthy individuals. Through the body perfusion software postpro- cessing, HAP, HPP and APF of different lobes of liver and AP of different locations of pancreas, spleen were obtained and analyzed statistically. Results In the normal control group, HAP, APF of hepatic left lateral lobe were higher than those of right lobe of the liver（ P = 0.006,0. 012,0. 002,0. 004 ）, HPP was lower than that of the right lobe and left medial liver （P = 0.012, 0.007, 0.03 ）. In the cirrhosis group, HAP, HPP and APF among each lobe did not show a statistically sig- nificant difference（P 〉0.05）. HAP, HPP, APF among different Child Pugh grading of liver cirrhosis group and the con- trol group showed a statistically significant difference（H = 46. 12,31.71,61.37 ;P = 0. 000）. In normal control group, AP of the pancreatic head, body and tail were no statistically significant difference（ P 〉0.05 ）. In the cirrhosis group, AP of pancreatic body and tail were below than that of the head （P = 0.000, P = 0. 000）. Compared with the control group, AP of the spleen and pancreas were decreased in the cirrhosis group （t = 4. 836, 8. 467, 8. 548, 7. 854,P 〈 0.01 ）. Conclusion There is difference in hemodynamics among different liver lobes in normal individuals. The perfusion of each part of the normal pancreas is uniform. However, in the cirrhosis group, the hemodynamics among different liver lobes changes disap- pear and splenic, pancreatic perfusion are decreased.

关 键 词：体层摄影术 X线计算机 肝脏 灌注成像 肝硬化 

分 类 号：R816.5[医药卫生—放射医学]