不同Child-Pugh分级的血吸虫病性肝硬化患者肝脏CT灌注成像参数分析  

CT liver perfusion imaging parameters in patients with schistosomiasis-induced liver cirrhosis

作　　者：曾艳妮 韩军 刘良进 秦涛 毕俊英 Zeng Yanni;Han Jun;Liu Liangjin(Department of Radiology,Third Provincial Hospital,Wuhan 430030,Hubei Province,China)

机构地区：[1]江汉大学附属湖北省第三人民医院/附属湖北省中山医院放射科,武汉市430030 [2]华中科技大学同济医学院附属协和医院放射科

出　　处：《实用肝脏病杂志》2020年第5期691-694,共4页Journal of Practical Hepatology

基　　金：湖北省自然科学基金资助项目(编号:WJ2015MB127)。

摘　　要：目的探讨不同Child-Pugh分级的血吸虫病性肝硬化患者肝脏CT灌注成像参数的变化。方法2016年5月~2018年10月我院诊治的血吸虫病性肝硬化患者40例(Child A级12例,B级16例和C级12例)和同期健康人40例,接受螺旋CT检查,应用CT Perfusion 4D肝脏灌注软件包处理肝脏灌注的相关数据,包括平均通过时间(MTT)、肝动脉分数(HAF)、肝动脉灌注量(HAP)、血容量(BV)和肝血流量(BF)等参数。结果健康人肝脏CT检测的BV、BF、MTT、HAF和HAP分别为(45.7±8.4)mL/100g、(212.6±43.3)mL/min·100g、(13.5±2.3)s、(0.2±0.0)和(16.3±8.3)mL/min·100g,而Child A级患者分别为(41.0±15.3)mL/100g、(185.6±38.4)mL/min·100g、(15.2±1.2)s、(0.2±0.0)和(20.5±8.0)mL/min·100g,Child B级分别为(38.5±20.6)mL/100g、(126.6±90.5)mL/min·100g、(19.4±11.4)s、(0.3±0.0)和(26.7±2.0)mL/min·100g,Child C级分别为(23.3±8.7)mL/100g、(129.4±46.6)mL/min·100g、(27.5±2.7)s、(0.4±0.1)和(35.2±12.6)mL/min·100g,肝硬化与健康人及不同Child分级的肝硬化患者之间,差异显著(P<0.05)。结论血吸虫病性肝硬化肝脏CT检查能提供形态学改变信息,CT灌注成像参数可以较好地评估肝硬化程度。Objective The aim of this study was to analyse the CT liver perfusion imaging parameters in patients with schistosomiasis-induced liver cirrhosis.Methods 40 patients with schistosomiasis-induced liver cirrhosis(Child A in 12,B in 16 and C in 12)and 40 healthy persons were recruited in our hospital between May 2016 and October 2018,and all of them underwent liver perfusion of spiral CT scanning.The blood volume(BV),blood flow(BF),mean transit time(MTT),hepatic artery fraction(HAF)and hepatic artery perfusion(HAP)were obtained by CT Perfusion 4D software.Results The BV,BF,MTT,HAF and HAP in healthy persons were(45.7±8.4)mL/100g,(212.6±43.3)mL/min·100g,(13.5±2.3)s,(0.2±0.0)and(16.3±8.3)mL/min·100g,while in patients with Child class A were(41.0±15.3)mL/100g,(185.6±38.4)mL/min·100g,(15.2±1.2)s,(0.2±0.0)and(20.5±8.0)mL/min·100g,in patients with Child class B were(38.5±20.6)mL/100g,(126.6±90.5)mL/min·100g,(19.4±11.4)s,(0.3±0.0)and(26.7±2.0)mL/min·100g,and in with Child class C were(23.3±8.7)mL/100g,(129.4±46.6)mL/min·100g,(27.5±2.7)s,(0.4±0.1)and(35.2±12.6)mL/min·100g,respectively,showing significantly different among the four groups(P<0.05).Conclusion CT liver perfusion imaging parameters might be used to evaluate the liver functions and cirrhosis in schistosomiasis-induced liver cirrhosis,which is worthy of further investigation.

关 键 词：血吸虫病性肝硬化 CHILD-PUGH分级 多层螺旋CT 灌注成像 血流参数 

分 类 号：R532.2[医药卫生—内科学] R575.2[医药卫生—临床医学]