基于正常肝脏Couinaud分段的MSCT全肝灌注研究  

MSCT perfusion study of whole-liver based on Couinaud's hepatic segments in normal liver

作　　者：李梦迪 

机构地区：[1]宁夏医科大学,宁夏银川750004\[2]宁夏医科大学总医院放射科

出　　处：《实用放射学杂志》2015年第4期575-579,共5页Journal of Practical Radiology

基　　金：国家自然基金项目(61061005).

摘　　要：目的：通过多层螺旋 CT(MSCT)全肝灌注模式,探讨正常肝脏 Couinaud 各段血流状态的特点。方法选择胃癌及胰腺恶性肿瘤患者73例,应用 MSCT 进行全肝灌注增强扫描,排除肝转移7例、多发肝囊肿(病灶直径>3 cm)6例、不同程度肝硬化6例、肝脏或脾脏手术史致肝段或脾缺如3例、肝内胆管扩张1例、运动伪影过大4例,最终纳入正常肝脏46例,并分别测定各段灌注参数值以评价正常肝脏各段的血流动力学状态。结果正常肝脏 S3段 HAP 与 S6、S7、S8以及 S4段 HAP 与 S7段存在统计学意义(P <0.05),S3段 HPI 与 S7段存在统计学意义(P <0.05)。在不同年龄组(A 组：<60岁,B 组：≥60岁)正常肝脏各段之间灌注参数值无统计学意义(P >0.05),但 A 组的血流灌注参数值大体高于 B 组。不同性别正常肝脏各段之间血流灌注参数值无统计学意义。结论正常肝脏各段的血流灌注情况不尽相同,MSCT 全肝脏灌注成像能更全面地反映正常肝脏血流动力学的变化,可为临床评估肝脏疾病提供影像学基础。Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.

关 键 词：CT灌注成像 肝脏 血流动力学 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.47[医药卫生—放射医学]