肝纤维化CT灌注成像评价肝功能储备  

CT perfusion parameters evaluate the liver reserve function of hepatic fibrosis-an experimental research

作　　者：廖锦元[1] 黎宁钦[1] 苏文[1] 

机构地区：[1]广西医科大学第一附属医院放射科,南宁530021

出　　处：《中华实验外科杂志》2016年第10期2320-2323,共4页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金（81360220）;广西自然科学基金（2010GXNSFA013189）

摘　　要：目的 探讨家兔肝纤维化制备过程中CT灌注参数评价肝功能储备的价值.方法 新西兰大白兔48只,雌雄不限,3-4个月龄,体重2.5 -3.0 kg,采用四氯化碳复合因素法造模,于造模的0、4、8、12、16、20周随机取8只兔检测肝功能生化指标,行CT灌注成像及吲哚氰绿排泄试验（R15ICG）、肝组织病理检查.统计学分析不同病理级别下肝功能生化指标、CT灌注参数与R15ICG的相关性.结果 （1）实验兔死亡5只,获得肝纤维化S0、S1、S2、S3及S4分别为10、9、9、8、7只.（2）从S0到S4期,R15ICG逐渐升高（5.31±2.71）％、（12.73±7.87）％、（19.85±12.64）％、（23.13±11.39）％、（31.59 ±23.88）％,组间比较差异有统计学意义（P＜0.01）.（3） R15ICG与总胆红素（T.BIL）、凝血酶原时间（PT）、肌酐（Cr）、天冬氨酸转氨酶（AST）、谷氨酸转氨酶（ALT）呈正相关（r =0.774、0.696、0.769、0.667、0.638）,与白蛋白（ALB）呈负相关（r=-0.782）;多元回归逐步剔除法分析,CT灌注参数血流量（BF）、肝动脉灌注分数（HAF）值为影响R15ICG的显著变量（P＜0.05）.结论 四氯化碳复合因素法成功制备兔肝纤维化模型,R15ICG与肝纤维化肝功能呈线性相关关系,CT灌注参数BF、HAF值为影响肝功能储备R15ICG的显著性指标.Objective To discuss the value of the CT perfusion parameters evaluate the liver reserve function in rabbit hepatic fibrosis model.Methods 48 New Zealand white rabbit,male or female,aged 3 months,weighing 2.5-3.0kg,were included in this study.Compound feed including carbon tetrachloride and phenobarbitone was employed to establish the liver fibrosis models.Liver samples of pathology were scored for fibrosis and biochemical indicators of liver function,indocyanine green retention rate at 15 minutes（R15ICG）,CT perfusion imaging were measured at the end of 0th,4th,8th,12th,16th,20th,weeks,respectively.Hepatic arterial fraction （HAF）,blood flow （BF）,blood volume （BV）,mean transit time （MTF）,permeability surface （PS） were measured.Correlation between the biochemical indicators and R15ICG,regression analysis of quantitative perfusion parameters and R15ICG were tested.Results （1） At the end of 20th week,there were 10,9,9,8,7 cases in stage S0 to S4 of hepatic fibrosis,respectively.（2） From stage S0 to S4,R15ICG were increased （5.31 ± 2.71）%,（12.73 ± 7.87）%,（19.85 ± 12.64） %,（23.13 ± 11.39） %,（31.59 ± 23.88） %,P 〈 0.01.（3） Positive correlation were found between R15ICG and T.BIL,PT,Cr,AST,ALT （r=0.774,0.696,0.769,0.667,0.638）,however,negative correlation between ALB （r =-0.782）.At regression analysis,only the BF,HAF was the significant factors of liver reserve function （P 〉 0.05）.Conclusion Multi-slice CT Perfusion can detect the changes of blood flood of liver fibrosis,R15ICG and hepatic fibrosis liver function is a linear relationship;BF,HAF appears to be the most promising perfusion parameter value affect the liver reserve function R15ICG in hepatic fibrosis.

关 键 词：肝纤维化 兔 CT灌注成像 肝功能储备 吲哚氰绿15分钟滞留率 

分 类 号：R575.2[医药卫生—消化系统] R816.5[医药卫生—内科学]