能谱 CT 容积穿梭灌注成像联合体积测量对肝硬化储备功能的评价  

Evaluation of the cirrhotic liver reserve function with shuttle spectrum CT perfusion imaging combined with volume measurement

作　　者：李勇[1] 李娜[2] 王成伟[1] 韩淑华[1] 

机构地区：[1]石河子大学医学院第一附属医院CT、MRI室,新疆石河子832008 [2]石河子大学医学院肿瘤内科

出　　处：《实用放射学杂志》2015年第2期242-246,共5页Journal of Practical Radiology

摘　　要：目的：探讨能谱CT容积螺旋穿梭灌注成像联合体积测量评价肝硬化肝功能储备的应用价值。方法肝硬化组30例及正常肝脏组30例均行 CT 肝体积测量和灌注成像,比较肝硬化组与正常肝脏组之间,肝硬化组肝功能 A、B、C 级之间的肝体积值,血流灌注参数值及肝体积-血流灌注乘积参数值的差异,并将肝功能分级分数与肝体积值、血流灌注参数值及肝体积-血流灌注综合参数值作相关性分析。结果肝硬化组 A、B、C 级肝体积（LV ）呈逐级递减,各组间有统计学差异（P 〈0.01）；肝硬化组血流灌注参数的肝血流量（BF）、肝血容量（BV）、平均通过时间（MTT）、肝动脉分数（HAF）与正常肝脏组相比,差异有统计学意义（P 〈0.01）；BF 和 BV 呈逐级递减,C 级与 A、B 级间有统计学差异（P 〈0.01）；肝体积-血流灌注指数（VBPI）呈逐级递减,各级间有统计学差异（P 〈0.01）；与其他指标相比,VBPI 与肝功能分级具有更高的相关性（r=-0.835,P 〈0.01）。结论肝体积及肝血流灌注参数的改变与肝硬化的临床分级相关,能谱 CT 容积螺旋穿梭灌注成像联合体积测量能准确地评价肝储备功能。Objective To investigate the application value of hepatic volume measurement combined with perfusion imaging using spectral CT volume helical shuttle scanning in evaluating the hepatic functional reserve in cirrhosis.Methods CT volume measure-ment of liver and CT perfusion imaging were performed in 30 patients with cirrhosis and in other 30 subjects with normal liver.The hepatic volume,parameters of blood flow perfusion and liver volume-perfusion index were observed and analyzed.Correlations be-tween graded fractions of hepatic function and liver volume,parameters of perfusion and liver volume-perfusion index were also ana-lyzed.Results The liver volume （LV）reduced gradually （P 〈0.01）with the grading of hepatic function from Grade A to C.There were significantly statistical differences in blood flow （BF）,blood volume （BV）and hepatic arterial fraction （HAF）between the nor-mal liver and cirrhosis.Differences in BF and BV were significant between Grade C and Grade A or B （P 〈0.01）.The liver volume-blood perfusion index （VBPI）reduced gradually with the grading from Grade A to C （P〈0.01）.The correlation of liver volume-per-fusion index with graded fractions of hepatic function was higher than that among other indexes.Conclusion Changes of volume and blood flow perfusion of the liver are related to the clinical grading of hepatic function.The volume measurement combined with spec-tral CT volume helical shuttle perfusion scanning will be a more comprehensive way in evaluating hepatic functional reserve.

关 键 词：能谱成像 计算机体层成像 肝体积 容积螺旋穿梭扫描 肝储备功能 

分 类 号：R814.42[医药卫生—影像医学与核医学] R575.2[医药卫生—放射医学]