双能量CT碘定量参数评估肝硬化患者肝脏血流灌注及肝功能的价值  

Value of dual-energy CT iodine quantification parameters in evaluating hepatic blood perfusion and liver function in patients with liver cirrhosis

作　　者：李真真[1] 耿云平[1] 尤国庆[1] 李飞[1] Li Zhenzhen;Geng Yunping;You Guoqing;Li Fei(Department of CT Imaging,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院CT影像科,473000

出　　处：《中国实用医刊》2021年第17期17-20,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析双能量CT碘定量参数评估肝硬化患者肝脏血流灌注及肝功能的价值。方法抽取2019年1月至2020年12月南阳市中心医院收治的肝硬化患者128例作为肝硬化组,并以1∶1配比抽取同期健康体检者128例作为健康对照组,均行双能量CT增强扫描。比较两组肝脏灌注参数[门静脉血流碘含量(PVIC)、肝动脉供血比重碘分数(AIF)、门静脉期肝实质碘浓度(Ip)、动脉期肝实质碘浓度(Ia)]、肝脏血流动力学参数[血流参数峰值(PV)、正性增强积分(PEI)、信号增强率(SER)]和肝硬化组不同Child-Pugh分级患者肝脏灌注参数、肝脏血流动力学参数,分析Child-Pugh分级和肝脏灌注参数、肝脏血流动力学参数的相关性。结果肝硬化组PVIC、Ip低于健康对照组,AIF、Ia高于健康对照组,差异有统计学意义(P<0.05);肝硬化组PV、PEI、SER高于健康对照组(P<0.05)。肝硬化组中,Child-Pugh C级患者PVIC、Ip低于A、B级患者,AIF、Ia高于A、B级患者,差异有统计学意义(P<0.05);Child-Pugh C级患者PV、PEI、SER低于A、B级患者(P<0.05)。Pearson分析结果显示,Child-Pugh分级与PVIC(r=-0.516)、Ip(r=-0.534)、PV(r=-0.671)、PEI(r=-0.582)、SER(r=-0.635)呈负相关(P<0.05),与AIF(r=0.725)、Ia(r=0.649)呈正相关(P<0.05)。结论肝硬化患者肝脏血流动力学参数和肝脏灌注参数会出现异常表达,并与Child-Pugh分级具有显著相关性,双能量CT碘定量参数可为临床评估肝功能储备情况提供科学依据。Objective To analyze the value of dual-energy computed tomography(CT)iodine quantification parameters in evaluating hepatic blood perfusion and liver function in patients with liver cirrhosis.Methods A total of 128 patients with liver cirrhosis treated in Nanyang Central Hospital from January 2019 to December 2020 were selected as the cirrhosis group,and 128 patients who underwent healthy physical examination during the same period were selected as the healthy control group with a ratio of 1∶1,and they all underwent enhanced dual energy CT scanning.The hepatic perfusion parameters,including portal venous blood flow iodine content(PVIC),arterial iodine fraction(AIF),iodine concentration in hepatic parenchyma of portal venous phase(Ip)and iodine concentration in hepatic parenchyma of arterial phase(Ia),and hepatic hemodynamic parameters,including peak value of blood flow parameters(PV),positive enhancement integral(PEI)and signal enhancement rate(SER),were compared between the two groups.The hepatic perfusion parameters and hepatic hemodynamic parameters of patients with different Child-Pugh grades in the cirrhosis group were compared.The relationship of Child-Pugh classification with hepatic perfusion parameters and hepatic hemodynamic parameters was analyzed.Results PVIC and Ip in the cirrhosis group were lower than those in the healthy control group,and AIF and Ia were higher than those in the healthy control group,and the difference was statistically significant(P<0.05).The PV,PEI and SER of the liver cirrhosis group were higher than those of the healthy control group,and the difference was statistically significant(P<0.05).In the liver cirrhosis group,the PVIC and Ip of patients with Child-Pugh grade C were lower than those of patients with Child-Pugh grade A and B,while AIF and Ia were higher than those of patients with Child-Pugh grade A and B(P<0.05).In the liver cirrhosis group,the PV,PEI and SER of patients with Child-Pugh grade C were lower than those of patients with Child-Pugh grade A and B(P<0.05).P

关 键 词：肝硬化 双能量CT碘定量参数 肝脏血流灌注 肝功能 

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