256层MSCT全肝灌注对肝脏各肝段灌注的差异性研究  

Study on the Differences between Each Hepatic Segment Perfusion Using 256-Slice MSCT Whole Liver Perfusion Scanning

作　　者：殷允娟[1,2] 侯海燕[1,2] 王均干[1,2] 吴国华[1,2] 姜建威[1,2] 

机构地区：[1]南通大学第三附属医院 [2]无锡市第三人民医院影像科,214041

出　　处：《临床放射学杂志》2014年第10期1520-1523,共4页Journal of Clinical Radiology

基　　金：无锡市医院管理中心医学技术重大项目资助项目(编号:YGZF1108)

摘　　要：目的依据Couinaud八段法,应用256层MSCT行全肝灌注,测量得出正常肝脏各段及左右叶各灌注参数值并行统计学分析,为肝脏疾病灌注提供基本的参照依据。方法搜集肝功能正常患者20例,应用JOG技术行全肝灌注扫描,扫描数据经灌注软件分析,依据Couinaud八段法得出肝脏八段及左右叶灌注各参数值,并应用统计学软件分析各参数间差异有无统计学意义,组间比较采用单因素方差分析和配对样本t检验。结果本组病例测得正常肝实质灌注量分别为：肝动脉灌注量（HAP）：（12.71±2.28）ml·min^-1·100 ml^-1;门静脉灌注量（HPP）：（56.65±2.54）ml·min^-1·100 ml^-1;总肝灌注量（TLP）：（69.88±1.92）ml·min^-1·100 ml^-1;肝动脉灌注指数（HAPI）=（18.87±2.74）%;HAP/HPP=1/3～1/4。第Ⅰ～Ⅷ段间HAP、HPP、TLP与HAPI间比较的F值分别为1.653、0.138、0.154、1.419;P值分别为0.125、0.995、0.993、0.201,均〉0.05,差异无统计学意义。肝脏左右叶间HAP、HPP、TLP与HAPI间比较,t值分别为1.686（P=0.1）、-0.228（P=0.821）、0.407（P=0.686）、1.50（P=0.142）,P值亦均〉0.05,差异无统计学意义。本组患者的有效剂量为7.2～13.49 mSv,平均（11.45±1.74）mSv。结论应用256层MSCT行全肝灌注,正常肝脏左右叶及各段各灌注参数间差异无统计学意义。Objective To measure the CT perfusion parameters of the normal hepatic segments and lobes,based on Couinaud eight segment classification of the liver,by using 256-slice MSCT scanning,and to provide the basic reference for the determination of hepatic disease＇s perfusion.Methods Twenty patients with normal hepatic functions underwent the whole hepatic perfusion with JOG technique.The scanning data were analyzed using the perfusion software.The perfusion values of each of the eight hepatic segments classified by the Couinaud as well as the left and right hepatic lobes were obtained.The perfusion values were statistically analyzed with the statistical software,and one-factor ANOVA and the pairedt test methods were employed.Results The HAP,HPP,TLP and HAPI of normal hepatic parenchyma were（12.71 ±2.28） ml·min^- 1·100 ml^- 1,（56.65 ±2.54） ml·min^- 1·100 ml^- 1,（69.88 ±1.92） ml·min- 1·100 ml- 1,（18.87 ± 2.74） % respectively with HAP /HPP=1 /3- 1 /4.The F values between HAP,HPP,TLP and HAPI of segment I to VIII were 1.653,0.138,0.154 and 1.419 respectively; accordingly the P values were 0.125,0.995,0.993 and 0.201.The differences were not statistically significant（P 0.05）.Comparison of HAP,HPP,TLP and HAPI between the left lobe and the right lobe showed that t values were 1.686（P=0.1）,- 0.228（P=0.821）,0.407（P=0.686） and 1.50（P =0.142） respectively.In this group cases,the effective doses（ED） ranged from 7.2 to 13.49 mSv,with an average of（11.45 ± 1.74） mSv.Conclusion This study indicates that no significant differences in perfusion parameters exist between each other of the eight hepatic segments as well as between the left and right hepatic lobes.

关 键 词：肝脏 全肝灌注 体层摄影术 X线计算机 肝段 

分 类 号：R816.5[医药卫生—放射医学]