应用四维CT灌注技术分析肝切除术后大鼠残肝微循环血流动力学变化  

Analysis of hemodynamic changes of microcirculation after different partial hepatectomy for rat models with 4D-CT perfusion imaging

作　　者：谢佩怡[1] 全力[1] 任杰 张英才 姜楠 张建生[1] 孟晓春[1] 朱康顺[1] 单鸿[1] 

机构地区：[1]中山大学附属第三医院放射科 [2]超声科 [3]肝移植科,广东广州510630

出　　处：《中国医学影像技术》2014年第2期171-175,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81201090、30901465);广东省自然科学基金(S2012010008367);教育部第43批留学回国人员科研启动基金广东省科技计划项目(2010B031600053);高校基本业务费青年教师培育项目(12ykpy47)

摘　　要：目的应用四维CT灌注(4D-CTP)技术研究不同比例肝切除(PH)术后大鼠残肝微循环血流动力学变化。方法将144只SD大鼠随机分入假手术(sham)组及50%、60%、70%、80%PH组,每组24只,余24只做补充实验。术后1h、1、3和7天,sham组和手术组各取6只大鼠行4D-CTP检查,计算肝动脉灌注量(HAP)、门静脉灌注量(PVP)、总肝灌注量(TLP)和肝动脉灌注指数(HPI),之后取肝脏行病理学检查。结果共21只大鼠符合小肝综合征(SFSS)表现,70%PH组1只,80%PH组20只。各PH组PVP、TLP均于术后1h达峰值,术后1天下降,术后3、7天趋于稳定;50%、60%PH组HAP、HPI术后1h、1天降低,3天和7天略增高;70%、80%PH组HAP术后1h最高,术后1、3、7天逐渐下降,HPI于术后1h显著降低,术后1天进一步轻度降低,术后3、7天稍增高。术后1h,80%PH组PVP、TLP高于50%、60%PH组和sham组(P均<0.05),HPI低于sham组(P<0.05);术后1天,80%PH组PVP、TLP高于sham组(P均<0.05),HPI低于sham组(P<0.05);术后3、7天各组PVP、TLP、HPI、HAP差异均无统计学意义(P均>0.05)。结论应用4D-CTP技术可定量分析大鼠PH术后残肝血流动力学变化,有效区分肝动脉、门静脉血流灌注异常。Objective To observe microcirculatory hemodynamic changes of remnant liver after partial hepatectomy （PH） with different proportions for rat models using four-dimensional CT perfusion （4D-CTP） technique. Methods A total of 144 SD rats were randomly divided into sham group, 50o//00, 600//00, 70%, 80% PH group and supplemental group （n=24） At 1 h, 1 day, 3 days and 7 days after PH operation, 4D-CTP scan was administrated for 6 rats from each group. Hepat- ic artery perfusion （HAP）, portal vein perfusion （PVP）, total liver perfusion （TLP） and hepatic perfusion index （HPI） were calculated based on 4D-CTP raw data. Then the remnant liver was taken for histopathological analysis. Results Small-for-size syndrome （SFSS） was found in 21 rats, 1 in 70% PH group and 20 in 80% PH group. In all PH groups, PVP and TLP increased and reached to the peak value 1 h after operation, descended 1 day after operation, stabilized 3 and 7 days after operation. In 50% and 60% PH group, HPI and HAP descended 1 h and 1 day after operation, increased 3 and 7 days after operation. In 70%//00 and 80%//00 PH group, HAP increased and reached to the peak value 1 h after operation, descended 1, 3 and 7 days after operation, HPI descended 1 h and 1 day after operation, increased 3 and 7 days after opera- tion. At 1 h after operation, in 80% PH group, PVP and TLP were significantly higher than those in 50% and 60% PH groups, as well as in sham group （all P〈O. 05）, HPI was significantly lower than that in sham group （P〈0. 05）. One day after operation, PVP and TLP in 80% PH group were still higher than those in sham group （all P〈0.05）, HPI was sig- nificantly lower than that in sham group （P〈0.05）. Three and 7 days after operation, there was no significant difference of PVP, TLP＇, HAP, HPI among all groups （all P〈0.05）. Conclusion Using 4D-CTP, hemodynamic changes of micro- circulatory for remnant liver rat after PH can be obtained quantatively, which can effectively distinguish hepatic

关 键 词：肝切除术 体层摄影术 x线计算机 血流动力学 灌注成像 

分 类 号：R332[医药卫生—人体生理学] R814.42[医药卫生—基础医学]