64排螺旋CT肝脏灌注对血吸虫性肝硬化的诊断价值分析  

Diagnostic value of 64 slice spiral CT liver perfusion for schistosomiasis cirrhosis

作　　者：王忠[1] 付兵[1] 杨智[1] 覃由宣[1] 彭竹琴[1] 叶娅妮 甘昭平 WANG Zhong;FU Bing;YANG Zhi;YAN You-xuan;PENG Zhu-qin;YE Ya-ni;GAN Zhao-ping(The Fifth People＇s Hospital of Chenzdu,Sichuan,611130,China)

机构地区：[1]成都市第五人民医院,四川成都611130 [2]西南兵工成都医院 [3]陕西省结核病防治院

出　　处：《中国地方病防治》2018年第4期449-449,451,共2页Chinese Journal of Control of Endemic Diseases

基　　金：2016年四川省卫生和计划生育委员会科研课题;16PJ057

摘　　要：目的探讨64排螺旋CT肝脏灌注对血吸虫性肝硬化的诊断价值。方法选取本院2017年3月至2018年3月来本院治疗的血吸虫性肝硬化患者68例为研究组,并使用涂蓉肝硬化的CT分级法分为轻度血吸虫性肝硬化患者、中度血吸虫性肝硬化患者以及重度血吸虫性肝硬化,选取同时期来本院体检的健康者20例作为对照组,对两组患者进行64排螺旋CT肝脏灌注扫描。结果研究组的BF和BV值明显低于对照组(P<0.05),研究组的MTT明显延长,其HAP高于对照组(P<0.05);与对照组进行比较,随着血吸虫性肝硬化程度的增加,BF和BV呈现下降的趋势,与血吸性肝硬化的严重程度呈现负相关的关系。MTT、HAP、HAF呈现出上升的趋势;CT平扫与CT增强扫描对肝硬化再生节的检出率无明显的变化(P>0.05),在肝硬化所并发的小肝癌的检测中,64排螺旋CT增强扫描的检出率明显高于CT平扫(P<0.05)。结论 64排螺旋CT肝脏灌注的成像参数能够在一定程度上对血吸虫性肝硬化的血流动力学的改变情况进行反应,能够为血吸虫性肝硬化的分级评估提供参考,有利于血吸虫性肝硬化的早期诊断,及早进行治疗措施的干预,提高治疗效果。Objective To study the diagnostic value of hepatic perfusion with 64 slice spiral CT in schistosomiasis cirrhosis.Methods 68 patients with schistosomiasis cirrhosis were selected as the study group,and the CT grading method of smear liver cirrhosis was used to divide the patients with mild schistosomiasis cirrhosis,moderate schistosomiasis cirrhosis and severe schistosomiasis cirrhosis,and 20 cases of healthy persons who had been examined at the same time in our hospital were selected. For the control group,two groups of patients underwent 64 slice spiral CT liver perfusion scan. Results The value of BF and BV in the study group was significantly lower than that of the control group（ P〈 0.05）. The MTT of the study group was significantly prolonged and the HAP was higher than that of the control group（ P〈 0.05）. Compared with the control group,with the increase of the degree of schistosomiasis,BF and BV showed a downward trend,which had a negative correlation with the severity of blood sucking cirrhosis.MTT,HAP and HAF showed an upward trend,and there was no significant change in the detection rate of CT scan and CT enhanced scan for the regeneration of liver cirrhosis（ P〈 0.05）. The detection rate of 64 row spiral CT enhanced scan was significantly higher than that of CT plain scan（ P〈 0.05） in the detection of liver cirrhosis complicated with small liver cancer.Conclusion The imaging parameters of 64 row spiral CT liver perfusion can respond to the hemodynamic changes of schistosomiasis cirrhosis to some extent. It can provide reference for grading evaluation of schistosomiasis cirrhosis. It is beneficial to the early diagnosis of schistosomiasis cirrhosis,and the intervention of treatment measures early and improve the therapeutic effect.

关 键 词：血吸虫性肝硬化 64排螺旋CT肝脏灌注 肝动脉分数 

分 类 号：R516.7[医药卫生—内科学]